Background: Gastric bezoars result from the accumulation of foreign ingested material in the form of masses or concretions. Bezoars are rare, being found in less than 1 percent of patients undergoing upper gastrointestinal endoscopy.
A large Trichobezoar has been traditionally removed by open surgery, which has entailed an upper abdominal incision. With the advent of laparoscopic surgery, it became feasible to retrieve a foreign body from the stomach without the necessity of a large skin incision in the upper abdomen
Case report: A 17-year-old girl presenting with abdominal pain, nausea, and appetite loss was admitted and evaluated. Results of an endoscopical gastric showed a large mass in the stomach that extended into the duodenum. Endoscopical removal had been tried twice under general anaesthesia and resulted only in the retrieval of the small portion of the Trichobezoar in the duodenum; total removal seemed impossible with endoscopic techniques.
Treatment: Laparoscopic removal was then under-taken to avoid the surgical scar in the upper abdomen. The Trichobezoar was successfully retrieved through a gastrotomy, using an “Endobag”, and was removed via a Small Mac Burney incision, with a minimal risk of contamination throughout the procedure.
Conclusion: This approach may be the treatment of choice for future cases of Trichobezoar when surgery is indicated. The authors recommend this approach for the treatment of patients with large gastric bezoars in whom laparotomy is indicated.
Program Number: P112