Giant Gastroduodenal Trichobezoar: An Endoscopic Surprise

A trichobezoar is a rare condition, mostly seen in teenage girls with abnormal psychiatric behavior of eating hairs and nails (trichophagia). Trichobezoar may rarely present with nonspecific abdominal symptoms without obvious trichotillomania and trichophagia. Trichobezoar can be complicated with potentially serious conditions such as gastric outlet obstruction, gastric bleeding, intussusceptions, and perforation peritonitis. Conventional laparotomy is method of choice for the removal of trichobezoar. We describe a rare case of giant trichobezoar treated by laparoscopic‑assisted gastrostomy and removal of bezoar. We also reviewed the literature on the current status of endoscopic treatment of trichobezoar.

Keywords

Endoscopic treatment - Rapunzel syndrome - trichobezoar

• References

• 1 Gorter RR, Kneepkens CM, Mattens EC, Aronson DC, Heij HA. Management of trichobezoar: Case report and literature review. Pediatr Surg Int 2010; 26: 457-63
• 2 Gonuguntla V, Joshi DD. Rapunzel syndrome: A comprehensive review of an unusual case of trichobezoar. Clin Med Res 2009; 7: 99-102
• 3 Nirasawa Y, Mori T, Ito Y, Tanaka H, Seki N, Atomi Y. et al Laparoscopic removal of a large gastric trichobezoar. J Pediatr Surg 1998; 33: 663-5
• 4 Tudor EC, Clark MC. Laparoscopic-assisted removal of gastric trichobezoar; a novel technique to reduce operative complications and time. J Pediatr Surg 2013; 48: e13-5
• 5 Zhao JL, Zhao WC, Wang YS. Endoscopic retrieval of gastric trichophytobezoar: Case report of a 12-year-old girl with trichophagia. Medicine (Baltimore) 2017; 96: e5969
• 6 Benatta MA. Endoscopic retrieval of gastric trichobezoar after fragmentation with electrocautery using polypectomy snare and argon plasma coagulation in a pediatric patient. Gastroenterol Rep (Oxf) 2016; 4: 251-3
• 7 Konuma H, Fu K, Morimoto T, Shimizu T, Izumi Y, Shiyanagi S. et al Endoscopic retrieval of a gastric trichobezoar. World J Gastrointest Endosc 2011; 3: 20-2
• 8 Aybar A, Safta AM. Endoscopic removal of a gastric trichobezoar in a pediatric patient. Gastrointest Endosc 2011; 74: 435-7
• 9 Saeed ZA, Ramirez FC, Hepps KS, Dixon WB. A method for the endoscopic retrieval of trichobezoars. Gastrointest Endosc 1993; 39: 698-700
• 10 Soehendra N. Endoscopic removal of a trichobezoar. Endoscopy 1989; 21: 201