Laparoscopic Removal of a Gastric Trichobezoar in Adulthood: A Case Report.

Abstract

Trichobezoars are hair concretions in the stomach associated with trichophagia and trichotillomania. In most cases, they occur among young women with concomitant mental disorders. The treatment for this category of patients involves surgical removal of trichobezoars. We present a case of a 24-year-old female patient who complained of morning nausea, a sensation of a foreign body, and periodic pulling pain in the epigastric region. Palpation revealed a foreign mass that occupied the epigastric area. The patient underwent computed tomography (CT) and esophagogastroduodenoscopy (EGD) for differential diagnosis. Based on the instrumental studies, the diagnosis of a gastric trichobezoar was established. Laparoscopic gastrotomy was performed along the anterior wall of the stomach with removal of the trichobezoar through a Pfannenstiel-type mini-laparotomy site. The postoperative period was uneventful, and the patient was discharged on the second postoperative day. To prevent recurrence, psychiatric consultation and long-term outpatient follow-up were recommended as part of treatment. The uniqueness of this case lies in the presence of a trichobezoar that caused minimal discomfort for a long period of time. Laparoscopic removal of gastric trichobezoars represents an effective treatment option due to its minimally invasive nature and rapid postoperative recovery.