Filipi C J, Perdikis G, Hinder R A, DeMeester T R, Fitzgibbons R J, Peters J
Department of Surgery, Creighton University School of Medicine, Omaha, NE 68136, USA.
Surg Endosc. 1995 Jul;9(7):831-3. doi: 10.1007/BF00190094.
Trichobezoars are difficult to remove endoscopically, often cause nausea and vomiting, and can result in small-bowel obstruction. A patient with a trichobezoar presented to our clinic with symptoms of partial small-bowel obstruction. Multiple attempts at flexible endoscopic removal were unsuccessful. Two large-diameter percutaneous gastrostomies with an inflatable balloon and distal foam-rubber stent to assure intragastric positioning were introduced under general anesthesia. Visualization was provided by a 0 degree panavision laparoscope placed through one of the gastrostomies. The bezoar was removed through the second gastrostomy using standard laparoscopic instruments. The patient made an uneventful recovery. This is the first reported case of percutaneous removal of a trichobezoar. We conclude large-diameter gastrostomies may serve as a port of access for numerous other intraluminal procedures.
毛发石很难通过内镜取出，常引起恶心和呕吐，并可导致小肠梗阻。一名患有毛发石的患者因部分小肠梗阻症状前来我们诊所就诊。多次尝试通过柔性内镜取出均未成功。在全身麻醉下，置入了两个带有可充气气球和远端泡沫橡胶支架的大口径经皮胃造口术，以确保胃内定位。通过其中一个胃造口置入的0度全景腹腔镜提供可视化。使用标准腹腔镜器械通过第二个胃造口取出毛发石。患者恢复顺利。这是首例经皮取出毛发石的报道病例。我们得出结论，大口径胃造口术可作为许多其他腔内手术的进入通道。
