{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:50:23Z","timestamp":1782301823219,"version":"3.54.5"},"reference-count":11,"publisher":"Gobierno de Navarra","issue":"1","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/deed.es"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["An Sist Sanit Navar"],"abstract":"<jats:p>Los bezoares son una causa poco frecuente de obstrucci\u00f3n intestinal y pueden tratarse mediante diversos enfoques. Dada la probabilidad de recidiva, los tratamientos invasivos o quir\u00fargicos no deben considerarse de inicio.\nPresentamos el caso de un hombre de 67 a\u00f1os con antecedentes de un fitobezoar g\u00e1strico gigante asintom\u00e1tico, que comenz\u00f3 a desarrollar s\u00edntomas suboclusivos. Se realiz\u00f3 una revisi\u00f3n de la literatura para resumir los enfoques terap\u00e9uticos disponibles para los bezoares gigantes, para los cuales no existen tratamientos de referencia establecidos. Se decidi\u00f3 entonces optar por un tratamiento conservador utilizando un complejo enzim\u00e1tico (Digeston Plus\u00ae), que incluye enzimas digestivas y bacterias probi\u00f3ticas. El paciente sigui\u00f3 el tratamiento durante tres meses, lograndose la resoluci\u00f3n de los s\u00edntomas y la desaparici\u00f3n casi completa del bezoar.\n\u00a0<\/jats:p>","DOI":"10.23938\/assn.1154","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T14:20:21Z","timestamp":1773066021000},"page":"e1154","source":"Crossref","is-referenced-by-count":0,"title":["Disoluci\u00f3n exitosa de un bezoar gigante tras tratamiento con complejo enzim\u00e1tico","Successful dissolution of a giant bezoar after enzyme complex therapy"],"prefix":"10.23938","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1981-4194","authenticated-orcid":false,"given":"Lucas","family":"Sabatella","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0404-9293","authenticated-orcid":false,"given":"Juan Jos\u00e9","family":"Gasc\u00f3n Jim\u00e9nez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Blanco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6557-0712","authenticated-orcid":false,"given":"Fernando","family":"Rotellar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7074-2849","authenticated-orcid":false,"given":"V\u00edctor","family":"Valent\u00ed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10024","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","first-page":"400","DOI":"10.5009\/gnl.2014.8.4.400","article-title":"Clinical outcomes associated with treatment modalities for gastrointestinal bezoars","volume":"8","author":"PARK","year":"2014","unstructured":"1. PARK SE, AHN JY, JUNG HY, NA S, PARK SJ, LIM H et al. Clinical outcomes associated with treatment modalities for gastrointestinal bezoars. Gut Liver 2014;8:400-407.","journal-title":"Gut Liver"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"2. IWAMURO M, OKADA H, MATSUEDA K, INABA T, KUSUMOTO C, IMAGAWA A et al. Review of the diagnosis and management of gastrointestinal bezoars. World J Gastrointest Endosc 2015;7:336. https:\/\/doi.org\/10.4253\/wjge.v7.i4.336","DOI":"10.4253\/wjge.v7.i4.336"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"3. PASCHOS KA, CHATZIGEORGIADIS A. Pathophysiological and clinical aspects of the diagnosis and treatment of bezoars. Ann Gastroenterol 2019;32:224-232.","DOI":"10.20524\/aog.2019.0370"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/0002-9610(75)90380-3","article-title":"Enzymatic dissolution of phytobezoars","volume":"130","author":"STANTEN","year":"1975","unstructured":"4. STANTEN A, PETERS HE. Enzymatic dissolution of phytobezoars. Am J Surg 1975;130:259-261.","journal-title":"Am J Surg"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"5. LI L, XUE B, ZHAO Q, XIE HQ, LUAN XR, CUI Q. Observation on the curative effect of long intestinal tube in the treatment of phytobezoar intestinal obstruction. Medicine (Baltimore) 2019;98:e14726. https:\/\/doi.org\/10.1097\/MD.0000000000014861","DOI":"10.1097\/MD.0000000000014861"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"128","DOI":"10.36740\/WLek202101125","article-title":"Stomach bezoaris, causes of development, diagnosis and methods of treatment","volume":"74","author":"VOROVSKIY","year":"2021","unstructured":"6. VOROVSKIY OO, SHUSHKOVSKA YY, AFANASIUK OI. Stomach bezoaris, causes of development, diagnosis and methods of treatment. Wiad Lek 2021;74:128-131.","journal-title":"Wiad Lek"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"7. MORELL B, BUEHLER PK, BADER PR, LANG S, SCHARL M, GUBLER C et al. Efficient treatment of esophageal nutrition bezoars: dissolution outmatches removal-the Zurich approach. Clin J Gastroenterol 2021;14:1602-1606. https:\/\/doi.org\/10.1007\/s12328-021-01516-1","DOI":"10.1007\/s12328-021-01516-1"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"8. GUPTA R, FELLOW GI, SHARE M, PINEAU BC. Dissolution of an esophageal bezoar with pancreatic enzyme extract. Gastrointest Endosc 2001;54:96-99. https:\/\/doi.org\/10.1067\/mge.2001.115318","DOI":"10.1067\/mge.2001.115318"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"9. CARREIRA DELGADO M, FERN\u00c1NDEZ RODR\u00cdGUEZ E, NU\u00d1O V\u00c1ZQUEZ-GARZA JM, GIL LLORENS C, V\u00c1ZQUEZ L\u00d3PEZ C. Oclusi\u00f3n intestinal por fitobezoar recidivante: resoluci\u00f3n con tratamiento no operatorio mediante celulasa. Cir Esp 2014;92:434-435. https:\/\/doi.org\/10.1016\/j.cireng.2012.07.006","DOI":"10.1016\/j.cireng.2012.07.006"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"10. KANTARCEKEN B, BULBULOGLU E, CIRALIK H, CETINKAYA A, EZBERCI F. Small-bowel obstruction due to a gastric bezoar during enzymatic treatment. Eur Surg 2005;37(4):259-261. http:\/\/dx.doi.org\/10.1007\/s10353-005-0172-1","DOI":"10.1007\/s10353-005-0172-1"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"11. LADAS SD, KAMBEROGLOU D, KARAMANOLIS G, VLACHOGIANNAKOS J, ZOUBOULIS-VAFIADIS I. Systematic review: Coca-Cola can effectively dissolve gastric phytobezoars as a first-line treatment. Aliment Pharmacol Ther 2013;37:169-173. https:\/\/doi.org\/10.1111\/apt.12141","DOI":"10.1111\/apt.12141"}],"container-title":["Anales del Sistema Sanitario de Navarra"],"original-title":[],"link":[{"URL":"https:\/\/recyt.fecyt.es\/index.php\/ASSN\/article\/download\/118336\/87131","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/recyt.fecyt.es\/index.php\/ASSN\/article\/download\/118336\/87131","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:25:14Z","timestamp":1782300314000},"score":1,"resource":{"primary":{"URL":"https:\/\/recyt.fecyt.es\/index.php\/ASSN\/article\/view\/118336"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,9]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,2,10]]}},"URL":"https:\/\/doi.org\/10.23938\/assn.1154","relation":{},"ISSN":["2340-3527","1137-6627"],"issn-type":[{"value":"2340-3527","type":"electronic"},{"value":"1137-6627","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3,9]]}}}