Abstract
Introduction:
Gastric trichobezoar is a rare gastrointestinal condition, more frequent in young female patients, and is often associated with trichophagia or other psychiatric disorders. It was first described in 1950. 1 Once in the stomach, human hair resists digestion and, because of its smooth surface, it is not pushed by the peristalsis. Mucus and food residues accumulate together with the hair, originating a solid mass named trichobezoar. The symptoms appear once the bezoar increases in volume. Gastric outlet obstruction is usually the first symptom. 2 Some complications may occur, such as gastric wall perforation or mucosal ulceration. 3 Mechanical removal of the bezoar is the only therapeutic method available. Endoscopic attempts may be frustrating, because of the bezoar size, but are described with success. 4 Surgical removal is the more effective option and laparoscopy is a feasible and less invasive procedure. In this video, we show a laparoscopic resection of a gastric trichobezoar, utilizing a Pfannenstiel incision to remove the specimen.
Materials and Methods:
We performed a laparoscopic resection of a gastric trichobezoar in a 14-year-old female patient with trichophagia antecedent. She was admitted to the emergency room with upper abdomen pain and distension. Physical examination revealed a solid palpable mass in the epigastric region, extending to the right flank. Abdominal computed tomography revealed a well-defined mass, occupying the entire lumen of the stomach. Laparoscopic excision was performed and the surgical specimen was removed by a Pfannenstiel incision. The operative time was of 60 minutes with no blood loss. The postoperative period was uneventful, the nasogastric tube was removed, and liquid diet was offered the day after surgery. The patient was discharged 2 days after surgery.
Results and Conclusions:
Laparoscopic removal of gastric trichobezoar is a feasible and less invasive surgical procedure. Pfannenstiel incision is an effective access to remove the specimen. Psychiatric follow-up is recommended.
No competing financial interests exist
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Runtime of video: 4 mins 14 secs
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