Department of General Surgery, Pediatric Surgery Unit, Faculty of Medicine, Tanta University, Tanta, Egypt.
Department of General Surgery, Gastrointestinal Surgery Unit, Faculty of Medicine, Tanta University, Tanta, Egypt.
Afr J Paediatr Surg. 2024 Apr 1;21(2):101-106. doi: 10.4103/ajps.ajps_104_22. Epub 2023 Feb 14.
Bezoars are indigestible lumps which are usually found in stomach. Types of bezoar include phytobezoar, trichobezoar, lithobezoar, pharmacobezoar, plasticobezoar, lactobezoar and metal bezoar. Trichobezoars mostly affect females in 20s and 30s with a rarity in paediatrics. Unexplained complaints with a palpable mass are commonly found in these patients. Treatment involves retrieval of mass with searching for others. The purpose of this study was to present data and surgical management of cases with trichobezoars.
We documented a retrospective review of trichobezoars done in our hospital between 2016 and 2022. All demographic data collected included gender and age of cases, composition and extent of bezoar, clinical presentation, imaging modalities, endoscopic trial, surgical approach and outcome.
Five cases of gastrointestinal tract (GIT) trichobezoars underwent surgery. All cases were females between (13 and 16 years). Trichobezoars were three gastric, one ileal and one of combined gastric and colonic. Complaints were abdominal pain, vomiting, weight loss and halitosis. Three cases had a palpable abdominal mass. Different radiological modalities were performed. Endoscopic retrieval was tried in one patient and the laparoscopic approach in another one, but the first route failed. Laparotomy followed by gastrotomy, enterotomy and colotomy was done without complications.
Trichobezoars should be suspected in any child with unexplained abdominal complaints or with a palpable abdominal mass, especially in girls. Imaging can be done in different modalities for diagnosis. Endoscopic retrieval could be tried; however, its failure is common, necessitating laparotomy, which has an excellent outcome.
胃石是一种难以消化的团块，通常在胃中发现。胃石的类型包括植物性胃石、毛发性胃石、胆石性胃石、药源性胃石、塑料性胃石、乳酸性胃石和金属性胃石。毛发性胃石主要影响 20 多岁和 30 多岁的女性，儿科中罕见。这些患者常出现不明原因的投诉和可触及的肿块。治疗方法包括取出肿块并寻找其他肿块。本研究旨在介绍我们医院在 2016 年至 2022 年期间治疗毛发性胃石病例的数据和手术管理。
我们对我院 2016 年至 2022 年期间进行的毛发性胃石病例进行了回顾性研究。收集的所有人口统计学数据包括病例的性别和年龄、胃石的成分和范围、临床表现、影像学检查、内镜检查、手术方法和结果。
5 例胃肠道（GIT）毛发性胃石患者接受了手术。所有病例均为 13 至 16 岁的女性。胃石有 3 个，回肠石 1 个，胃和结肠石 1 个。症状为腹痛、呕吐、体重减轻和口臭。3 例有可触及的腹部肿块。进行了不同的影像学检查。尝试了 1 例内镜取出和 1 例腹腔镜治疗，但前者失败。进行了剖腹探查，随后进行胃切开术、肠切开术和结肠切开术，无并发症发生。
任何出现不明原因的腹部症状或可触及腹部肿块的儿童，尤其是女孩，都应怀疑毛发性胃石。可以通过不同的方式进行影像学检查以明确诊断。可以尝试内镜取出，但失败常见，需要剖腹探查，手术效果良好。
