Laparoscopic Removal of a Large Gastric Trichobezoar in a 4-Year-Old Girl

Abstract

Laparoscopic removal of a large gastric trichobezoar is technically feasible through small incisions without requiring port-site extension or limited midline laparotomy.

Complete laparoscopic removal of a gastric trichobezoar

“…Of these only 3 were removed completely by laparoscopy alone without extension of the port site incisions. [15] Our patient is the youngest reported to date. The limiting factor is the size and fear of spillage and peritoneal contamination.…”

Giant Trichobezoar: A Rare Cause of Gastric Outlet Obstruction

“…Trichobezoar has several clinical and pathological features which warrant the attention from treating physicians. Its occurrence is predominantly observed in adolescents; nevertheless its incidence in children less than 10 years of age is on a rise [18,19]. Females with long hairs and psychiatric disturbances are more prone to have trichobezoars than the males [8,20,21].…”

The diagnosis and treatment of Rapunzel syndrome

“…In addition, it must be emphasized that the successful removal of large trichobezoars by laparotomy combined with anterior gastrotomy was confirmed by a retrospective analysis of 34 cases published in 2005 (11). Moreover, three reports have indicated the successful laparoscopic removal of trichobezoars in pediatric patients, of which two had Rapunzel syndrome (12–14). However, we still advocate the use of a laparoscopic approach only for appropriate patients due to increased operating time, the added risk of intra-abdominal spillage of the trichobezoar contents, and the necessity of extended incisions.…”