LAPAROSCOPIC REMOVAL OF A LARGE GASTRIC TRICHOBEZOAR

A large trichobezoar has been traditionally removed by open surgery, w hich has entailed an upper abdominal incision. With the advent of lapa roscopic surgery, it became feasible to retrieve a foreign body from t he stomach without the necessity of a large skin incision in the upper abdomen. A 7-year-old girl presenting with abdominal pain, nausea, an d appetite loss was admitted and evaluated. Results of an upper gastro intestinal series showed a large mass in the stomach that extended int o the duodenum. Endoscopical removal had been tried twice under genera l anesthesia and resulted only in the retrieval of the small portion o f the trichobezoar in the duodenum; total removal seemed impossible wi th endoscopic techniques, Laparoscopic removal was then undertaken to avoid the surgical scar in the upper abdomen. The trichobezoar was suc cessfully retrieved through a gastrotomy and removed via a small supra pubic incision. This approach may be the treatment of choice for futur e cases of trichobezoar when surgery is indicated. Copyright (C) 1998 by W.B. Saunders Company.