The Endoscopic Removal of a Gastric Bezoar Made of Sodium Zirconium Cyclosilicate Hydrate.

Sodium zirconium cyclosilicate hydrate (SZC) is a novel potassium binder that can be administered either orally or via nasogastric tubes. We report the case of a 77-year-old woman who developed a 37-mm gastric bezoar after nasogastric SZC administration during intensive care for acute adrenal insufficiency. Endoscopic removal was performed, and the analysis confirmed that the SZC was the primary constituent. Impaired gastric motility, acidic gastric environment, and limited hydration are likely contributors. This case highlights the potential for SZC-induced gastric bezoar formation in critically ill patients, and underscores the importance of imaging monitoring, careful gastrointestinal management, and the awareness of this potential complication during SZC therapy.