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Case Reports
. 2017 Jan;96(3):e5969.
doi: 10.1097/MD.0000000000005969.

Endoscopic retrieval of gastric trichophytobezoar: Case report of a 12-year-old girl with trichophagia

Affiliations
Case Reports

Endoscopic retrieval of gastric trichophytobezoar: Case report of a 12-year-old girl with trichophagia (VSports手机版)

Jiu-Ling Zhao et al. Medicine (Baltimore). 2017 Jan.

Abstract (VSports)

Rationale: Trichophytobezoars, which are composed of hair and plant fibers, are usually located in the stomach. They are often associated with trichophagia and trichotillomania. The most commonly reported methods of trichophytobezoar treatment are open surgery and laparoscopic retrieval; there are few reports of endoscopic removal of trichophytobezoars. VSports手机版.

Patient concerns and diagnoses: Twelve-year-old girl presented with a 3-day history of increasing upper abdominal pain, anorexia, and postprandial emesis. She had a 3-year history of pulling out and eating her own hair V体育安卓版. Endoscopic examination showed a large intragastric trichophytobezoar measuring 10. 5 cm × 3. 5 cm in size, with extension of a few hairs through the pylorus. .

Interventions and outcomes: The trichophytobezoar was packed with hair fibers and contained a hard core of mixed hair and vegetable fibers. After the core was cut, the trichophytobezoar was fragmented into pieces with the alternating use of a polypectomy snare and argon plasma coagulation. A small amount of hair and nondigestible food fibers was removed with grasping forceps during the initial procedure. The remaining hairball was loosened with biopsy forceps and was injected with sodium bicarbonate solution. The trichophytobezoar was removed completely at repeat endoscopy 5 days later. After 6 months of psychological intervention, the patient had no recurrence of trichophagia or trichophytobezoar V体育ios版. .

Lessons: Endoscopy with sodium bicarbonate injection is an effective and minimally invasive method of retrieving a gastric trichophytobezoar VSports最新版本. .

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Gastric bezoar on ultrasonography. Gray-scale abdominal ultrasonography reveals an arc-shaped intraluminal mass (blue arrow) with a strong posterior acoustic shadow (yellow arrows).
Figure 2
Figure 2
Endoscopic therapy. (A): Gastric trichophytobezoar at the first endoscopic treatment. (B) Some hair and nondigestible food fibers are retrieved during the initial endoscopy. (C) The gastric trichophytobezoar has loosened 5 days after initial treatment. (D) The trichophytobezoar is completely removed during the second endoscopy.
Figure 3
Figure 3
Nothing is present in the stomach at the third endoscopic examination.

References

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    1. Scorpio R, Sharma D. Terminal ileal trichophytobezoar with perforation: a rare presentation with review. J Indian Assoc Pediatr Surg 2008;13:38–40. - PMC - PubMed

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