title: Endoscopic retrieval of gastric trichophytobezoar: Case report of a 12-year-old girl with trichophagia.
abstract: BACKGROUND
  Trichophytobezoars, which are composed of hair and plant fibers, are usually located in the stomach. They are often associated with trichophagia and trichotillomania. The most commonly reported methods of trichophytobezoar treatment are open surgery and laparoscopic retrieval; there are few reports of endoscopic removal of trichophytobezoars.
  
  
  METHODS
  Twelve-year-old girl presented with a 3-day history of increasing upper abdominal pain, anorexia, and postprandial emesis. She had a 3-year history of pulling out and eating her own hair. Endoscopic examination showed a large intragastric trichophytobezoar measuring 10.5 cm × 3.5 cm in size, with extension of a few hairs through the pylorus.
  
  
  RESULTS
  The trichophytobezoar was packed with hair fibers and contained a hard core of mixed hair and vegetable fibers. After the core was cut, the trichophytobezoar was fragmented into pieces with the alternating use of a polypectomy snare and argon plasma coagulation. A small amount of hair and nondigestible food fibers was removed with grasping forceps during the initial procedure. The remaining hairball was loosened with biopsy forceps and was injected with sodium bicarbonate solution. The trichophytobezoar was removed completely at repeat endoscopy 5 days later. After 6 months of psychological intervention, the patient had no recurrence of trichophagia or trichophytobezoar.
  
  
  CONCLUSIONS
  Endoscopy with sodium bicarbonate injection is an effective and minimally invasive method of retrieving a gastric trichophytobezoar.
authors.affiliation: Department of Pediatrics, Tianjin Nankai Hospital Nankai Clinical School, Tianjin Medical University Department of Endoscopy, Tianjin Nankai Hospital, Nankai, Tianjin, China.
authors.forename: Jiu-Ling
authors.initials: JL
authors.lastname: Zhao
authors.forename: Wei-Chuan
authors.initials: WC
authors.lastname: Zhao
authors.forename: Yu-Shui
authors.initials: YS
authors.lastname: Wang
mesh_terms: D001630:Bezoars / Q000601:surgery*; D002648:Child; D005260:Female; D005773:Gastroscopy / Q000379:methods*; D006801:Humans