Qureshi N H, Morris K, McDevitt B
Dept of Surgery, Sligo General Hospital.
Ir Med J. 1992 Jun;85(2):74.
A twenty year old girl was referred to the surgical out-patients clinic with a history of intermittent epigastric pain and vomiting of five months duration. The patient enjoyed good health prior to this and her past medical history was uneventful. Findings on physical examination included pallor, patchy alopecia and a soft mobile, non-tender mass in the epigastrium and left upper quadrant of the abdomen. When questioned she admitted to a history of trichophagia for as long as she could recall. A provisional diagnosis of gastric trichobezoar was made. Radiological investigations included an abdominal ultrasound which showed a large ill-defined mass lesion with poor transonic features, situated in the upper abdomen and extending from the left upper quadrant across the midline to the liver margin. Barium meal revealed that the greater part of the lumen of stomach was occupied with material of an indeterminate nature. Her haematological investigations showed Haemoglobin 9.5 gm/dl and Leucocyte Count 9.0 x 10(9)/L. Her Urea and Electrolytes were within normal range. At laparotomy a large hair ball extending from the Stomach into the duodenum and proximal jejunum was removed through a vertical gastrotomy incision. The patient had a satisfactory post-operative convalescence and was discharged two weeks later.
一名20岁女孩因间歇性上腹部疼痛和呕吐5个月的病史被转诊至外科门诊。在此之前，患者身体健康，既往病史无异常。体格检查发现患者面色苍白、有斑秃，上腹部和左上腹有一个柔软、可移动、无压痛的肿块。经询问，她承认自能记事起就有吞食毛发的历史。初步诊断为胃毛石症。影像学检查包括腹部超声，显示上腹部有一个大的边界不清的肿块病变，超声穿透性差，位于上腹部，从左上象限延伸至中线并到达肝缘。钡餐检查显示胃腔大部分被性质不明的物质占据。她的血液学检查显示血红蛋白9.5克/分升，白细胞计数9.0×10⁹/L。尿素和电解质在正常范围内。在剖腹手术中，通过垂直胃切开术切口取出了一个从胃延伸至十二指肠和近端空肠的大毛球。患者术后恢复良好，两周后出院。
