Endoscopic retrieval of gastric trichophytobezoar

Zhao, Jingjing; Zhao, Weichuan; Wang, Yushui

doi:10.1097/md.0000000000005969

Cited by 11 publications

(7 citation statements)

References 24 publications

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“…In the endoscopic treatment of large trichobezoars, Zhao et al reported the usefulness of the injection of sodium bicarbonate solution into a trichobezoar but needed repeated endoscopic therapy. 7 It is well known that Coca-Cola can dissolve persimmon phytobezoars. Matsuoka et al, however, recently reported the usefulness of direct Coca-Cola injection into a large trichobezoar on endoscopic intervention, resulting in the complete removal of the large trichobezoar in one endoscopic intervention.…”

Section: Discussionmentioning

confidence: 99%

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Successful endoscopic treatment of a huge trichobezoar in a 10‐year‐old girl

Matsuura,

Oura,

Ishibashi

et al. 2024

DEN Open

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A 10‐year‐old girl was admitted to our hospital due to acute pancreatitis. Computed tomography showed an intra‐gastric mass containing multiple small air bubbles. Ultrasound showed a well‐circumscribed large oval mass with a broad acoustic shadow. Endoscopy revealed a huge trichobezoar with many movable hairs, being judged by the cause of acute pancreatitis. Due to the parents’ strong preference not to leave any surgical scars on their daughter, the patient underwent endoscopic treatment. The trichobezoar grasped with a snare was too large to pass through the esophageal‐gastric junction. In addition, the outer layer of the trichobezoar was too hard to be cut with conventional endoscopic devices but was successfully cut with a FlushKnife. The content of the trichobezoar was much softer than its hard surface but needed appropriate counter‐traction to be torn off the tissue. Two alligator forceps via a dual‐channel multi‐bending scope were able to give sufficient counter‐traction to the inner tissue of the trichobezoar, successfully removing the trichobezoar through piece‐by‐piece tearing off. All the endoscopic procedures took seven hours for the complete trichobezoar removal. The total weight of the dissected mass was 180 g. The girl resumed eating on the next day and was discharged on the third day. Physicians should note that a medical team with full endoscopic expertise can remove huge trichobezoars using a FlushKnife, a dual‐channel multi‐bending scope, and two alligator forcepses.

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Section: Discussionmentioning

confidence: 99%

“…In the endoscopic treatment of large trichobezoars, Zhao et al. reported the usefulness of the injection of sodium bicarbonate solution into a trichobezoar but needed repeated endoscopic therapy 7 . It is well known that Coca‐Cola can dissolve persimmon phytobezoars.…”

Section: Discussionmentioning

confidence: 99%

Successful endoscopic treatment of a huge trichobezoar in a 10‐year‐old girl

Matsuura,

Oura,

Ishibashi

et al. 2024

DEN Open

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“…Retrieval may need multiple endoscopic passes and a prolonged procedure time of up to 5 hrs. We have summarized case reports (Table 2) that have described the successful removal of trichobezoar endoscopically (14–23). These case reports are, however, outnumbered by cases reported where endoscopic removal was unsuccessful.…”

Section: Discussionmentioning

confidence: 99%

Trichobezoar: A Rare Cause of Protein-losing Enteropathy

Bashir¹,

Tejada²,

Oldham³

et al. 2023

JPGN Reports

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Protein-losing enteropathy (PLE) is caused by protein loss through the gastrointestinal tract which results in hypoalbuminemia. The most common causes of PLE in children include cow milk protein allergy, celiac disease, inflammatory bowel disease, hypertrophic gastritis, intestinal lymphangiectasia, and right-sided heart dysfunction. We present a case of a 12-year-old male with bilateral lower extremity edema, hypoalbuminemia, elevated stool alpha-1-antitrypsin, and microcytic anemia. He was found to have a trichobezoar in the stomach extending to the jejunum, an unusual cause of PLE. The patient underwent an open laparotomy and gastrostomy to remove the bezoar. Follow-up confirmed resolution of hypoalbuminemia.

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“…Benatta (17) used a polypectomy snare and APC (ERBE, VIO, 200 D; settings: effect 2; 40 W) to fragment an 8 cm × 4 cm trichobezoar and successfully removed it in 15 passes over 50 minutes. Zhao et al (18) applied APC to a 10.5 × 3.5 cm trichophytobezoar and divided it using endoscopic scissors removing it in 2 sessions.…”

Section: Discussionmentioning

confidence: 99%

“…The trichobezoar's weight may exert pressure on the mucosa, exerting a mechanical effect, which may lead to ischemia. The lesser curvature of the stomach is more vulnerable to perforation as Data from (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Mechanical Considerationsmentioning

confidence: 99%

Human and Doll's Hair in a Gastric Trichobezoar, Endoscopic Retrieval Hazards

Niță

Hill

Lindley

et al. 2020

J. pediatr. gastroenterol. nutr.

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Trichobezoars are masses of ingested hair, usually the individual's own hair, that accumulate in the gastrointestinal tract, most commonly in the stomach. When extending into the small intestine, this is termed “Rapunzel syndrome.” Removal has traditionally been by laparotomy; however, successful endoscopic removal has also been described. We report the case of a 9-year-old-girl with undiagnosed coeliac disease and Rapunzel syndrome who underwent endoscopic removal of a large trichobezoar, which was followed by unexpected multiple perforations of the small bowel and stomach. Argon plasma coagulation (APC) and snare electrocautery were employed during endoscopy to remove the trichobezoar piecemeal, and approximately 70% was removed without any clear signs of damage to the mucosa. It was discovered subsequently that about 20 of her dolls were found without hair. On investigating the composition of a specific doll hair from the manufacturer, it was discovered that it could be hazardous if burned. It was, therefore, hypothesized that a constellation of factors had conspired to lead to perforation, that is, the potentially hazardous gas produced from the electrical energy applied to the synthetic hair and possible mucosal damage by the physical abrasion of this hair. A review of the literature on endoscopic attempts to remove trichobezoars irrespective of the result reveals a success rate of 30.7%.

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Endoscopic retrieval of gastric trichophytobezoar

Abstract: Supplemental Digital Content is available in the text

Cited by 11 publications

References 24 publications

Successful endoscopic treatment of a huge trichobezoar in a 10‐year‐old girl

Successful endoscopic treatment of a huge trichobezoar in a 10‐year‐old girl

Trichobezoar: A Rare Cause of Protein-losing Enteropathy

Human and Doll's Hair in a Gastric Trichobezoar, Endoscopic Retrieval Hazards

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