Successful endoscopic treatment of a huge trichobezoar in a 10‐year‐old girl

Abstract A 10‐year‐old girl was admitted to our hospital due to acute pancreatitis. Computed tomography showed an intra‐gastric mass containing multiple small air bubbles. Ultrasound showed a well‐circumscribed large oval mass with a broad acoustic shadow. Endoscopy revealed a huge trichobezoar with...

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Main Authors: Ko Matsuura, Shoji Oura, Kohei Ishibashi, Yoichi Matsumoto, Wataru Ono
Format: Article
Language:English
Published: Wiley 2024-04-01
Series:DEN Open
Subjects:
Online Access:https://doi.org/10.1002/deo2.357
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author Ko Matsuura
Shoji Oura
Kohei Ishibashi
Yoichi Matsumoto
Wataru Ono
author_facet Ko Matsuura
Shoji Oura
Kohei Ishibashi
Yoichi Matsumoto
Wataru Ono
author_sort Ko Matsuura
collection DOAJ
description Abstract A 10‐year‐old girl was admitted to our hospital due to acute pancreatitis. Computed tomography showed an intra‐gastric mass containing multiple small air bubbles. Ultrasound showed a well‐circumscribed large oval mass with a broad acoustic shadow. Endoscopy revealed a huge trichobezoar with many movable hairs, being judged by the cause of acute pancreatitis. Due to the parents’ strong preference not to leave any surgical scars on their daughter, the patient underwent endoscopic treatment. The trichobezoar grasped with a snare was too large to pass through the esophageal‐gastric junction. In addition, the outer layer of the trichobezoar was too hard to be cut with conventional endoscopic devices but was successfully cut with a FlushKnife. The content of the trichobezoar was much softer than its hard surface but needed appropriate counter‐traction to be torn off the tissue. Two alligator forceps via a dual‐channel multi‐bending scope were able to give sufficient counter‐traction to the inner tissue of the trichobezoar, successfully removing the trichobezoar through piece‐by‐piece tearing off. All the endoscopic procedures took seven hours for the complete trichobezoar removal. The total weight of the dissected mass was 180 g. The girl resumed eating on the next day and was discharged on the third day. Physicians should note that a medical team with full endoscopic expertise can remove huge trichobezoars using a FlushKnife, a dual‐channel multi‐bending scope, and two alligator forcepses.
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publishDate 2024-04-01
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spelling doaj-art-ed5bb2d311c54fd4b15493e3e4d9d1d02025-08-20T03:38:54ZengWileyDEN Open2692-46092024-04-0141n/an/a10.1002/deo2.357Successful endoscopic treatment of a huge trichobezoar in a 10‐year‐old girlKo Matsuura0Shoji Oura1Kohei Ishibashi2Yoichi Matsumoto3Wataru Ono4Department of Gastroenterology Kishiwada Tokushukai Hospital Osaka JapanDepartment of Surgery Kishiwada Tokushukai Hospital Osaka JapanDepartment of Gastroenterology Kishiwada Tokushukai Hospital Osaka JapanDepartment of Pediatrics Kishiwada Tokushukai Hospital Osaka JapanDepartment of Gastroenterology Kishiwada Tokushukai Hospital Osaka JapanAbstract A 10‐year‐old girl was admitted to our hospital due to acute pancreatitis. Computed tomography showed an intra‐gastric mass containing multiple small air bubbles. Ultrasound showed a well‐circumscribed large oval mass with a broad acoustic shadow. Endoscopy revealed a huge trichobezoar with many movable hairs, being judged by the cause of acute pancreatitis. Due to the parents’ strong preference not to leave any surgical scars on their daughter, the patient underwent endoscopic treatment. The trichobezoar grasped with a snare was too large to pass through the esophageal‐gastric junction. In addition, the outer layer of the trichobezoar was too hard to be cut with conventional endoscopic devices but was successfully cut with a FlushKnife. The content of the trichobezoar was much softer than its hard surface but needed appropriate counter‐traction to be torn off the tissue. Two alligator forceps via a dual‐channel multi‐bending scope were able to give sufficient counter‐traction to the inner tissue of the trichobezoar, successfully removing the trichobezoar through piece‐by‐piece tearing off. All the endoscopic procedures took seven hours for the complete trichobezoar removal. The total weight of the dissected mass was 180 g. The girl resumed eating on the next day and was discharged on the third day. Physicians should note that a medical team with full endoscopic expertise can remove huge trichobezoars using a FlushKnife, a dual‐channel multi‐bending scope, and two alligator forcepses.https://doi.org/10.1002/deo2.357alligator forcepsdual‐channel multi‐bending scopeFlushKnifepancreatitistrichobezoar
spellingShingle Ko Matsuura
Shoji Oura
Kohei Ishibashi
Yoichi Matsumoto
Wataru Ono
Successful endoscopic treatment of a huge trichobezoar in a 10‐year‐old girl
DEN Open
alligator forceps
dual‐channel multi‐bending scope
FlushKnife
pancreatitis
trichobezoar
title Successful endoscopic treatment of a huge trichobezoar in a 10‐year‐old girl
title_full Successful endoscopic treatment of a huge trichobezoar in a 10‐year‐old girl
title_fullStr Successful endoscopic treatment of a huge trichobezoar in a 10‐year‐old girl
title_full_unstemmed Successful endoscopic treatment of a huge trichobezoar in a 10‐year‐old girl
title_short Successful endoscopic treatment of a huge trichobezoar in a 10‐year‐old girl
title_sort successful endoscopic treatment of a huge trichobezoar in a 10 year old girl
topic alligator forceps
dual‐channel multi‐bending scope
FlushKnife
pancreatitis
trichobezoar
url https://doi.org/10.1002/deo2.357
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AT shojioura successfulendoscopictreatmentofahugetrichobezoarina10yearoldgirl
AT koheiishibashi successfulendoscopictreatmentofahugetrichobezoarina10yearoldgirl
AT yoichimatsumoto successfulendoscopictreatmentofahugetrichobezoarina10yearoldgirl
AT wataruono successfulendoscopictreatmentofahugetrichobezoarina10yearoldgirl