Nirasawa Y, Mori T, Ito Y, Tanaka H, Seki N, Atomi Y
Department of Pediatric Surgery, Kyorin University Medical School, Shinkawa, Tokyo, Japan.
J Pediatr Surg. 1998 Apr;33(4):663-5. doi: 10.1016/s0022-3468(98)90342-6.
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 gastrointestinal 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 under-taken 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.
传统上，大型毛粪石需通过开腹手术取出，这需要在上腹部做切口。随着腹腔镜手术的出现，无需在上腹部做大的皮肤切口就能从胃中取出异物成为可能。一名出现腹痛、恶心和食欲减退的7岁女孩入院接受评估。上消化道造影结果显示胃内有一个巨大肿物，延伸至十二指肠。曾在全身麻醉下尝试内镜取出两次，仅取出了十二指肠内毛粪石的一小部分；似乎无法通过内镜技术完全取出。随后进行腹腔镜取出以避免上腹部手术瘢痕。通过胃切开术成功取出毛粪石，并经耻骨上小切口取出。对于未来有手术指征的毛粪石病例，这种方法可能是首选治疗方式。
