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Laparoscopic removal of a large gastric trichobezoar

  • Yuji Nirasawa
    Correspondence
    Address reprint requests to Yuji Nirasawa, MD, Department of Pediatric Surgery, Kyorin University Medical School, Shinkawa, Mitakashi, Tokyo, 181, Japan.
    Affiliations
    Department of Pediatric Surgery, Kyorin University Medical School, Shinkawa, Tokyo, Japan.

    Department of Surgery, Kyorin University Medical School, Shinkawa, Tokyo, Japan.
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  • Toshiyuki Mori
    Affiliations
    Department of Pediatric Surgery, Kyorin University Medical School, Shinkawa, Tokyo, Japan.

    Department of Surgery, Kyorin University Medical School, Shinkawa, Tokyo, Japan.
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  • Yasuo Ito
    Affiliations
    Department of Pediatric Surgery, Kyorin University Medical School, Shinkawa, Tokyo, Japan.

    Department of Surgery, Kyorin University Medical School, Shinkawa, Tokyo, Japan.
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  • Hiroyuki Tanaka
    Affiliations
    Department of Pediatric Surgery, Kyorin University Medical School, Shinkawa, Tokyo, Japan.

    Department of Surgery, Kyorin University Medical School, Shinkawa, Tokyo, Japan.
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  • Nobuo Seki
    Affiliations
    Department of Pediatric Surgery, Kyorin University Medical School, Shinkawa, Tokyo, Japan.

    Department of Surgery, Kyorin University Medical School, Shinkawa, Tokyo, Japan.
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  • Yutaka Atomi
    Affiliations
    Department of Pediatric Surgery, Kyorin University Medical School, Shinkawa, Tokyo, Japan.

    Department of Surgery, Kyorin University Medical School, Shinkawa, Tokyo, Japan.
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      Abstract

      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. A 7-year-old girl presenting with abdominal pain, nausea, and appetite loss was admitted and evaluated. Results of an upper gastro-intestinal series showed a large mass in the stomach that extended into the duodenum. Endoscopical removal had been tried twice under general anesthesia and resulted only in the retrieval of the small portion of the trichobezoar in the duodenum; total removal seemed impossible with endoscopic techniques. Laparoscopic removal was then undertaken to avoid the surgical scar in the upper abdomen. The trichobezoar was successfully retrieved through a gastrotomy and removed via a small suprapubic incision. This approach may be the treatment of choice for future cases of trichobezoar when surgery is indicated.

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