Endoscopic retrieval of gastric trichobezoar after fragmentation with electrocautery using polypectomy snare and argon plasma coagulation in a pediatric patient

Abstract

Trichobezoars are rare, composed of hair and more common in female pediatric patients with psychiatric disorders. Open surgical extraction is the most common removal method. Only two endoscopic removals after fragmentation have been reported in the English literature. We report herein a third case of a trichobezoar that was successfully retrieved after endoscopic fragmentation with snare polypectomy and argon plasma coagulation in a six-year-old female patient. The trichobezoar mass was completely removed in 10 pieces after 15 passes. The patient's course was uneventful. Nine months later, she is doing well. This endoscopic removal was effective, minimally invasive and time saving.

Keywords: endoscopic fragmentation; trichobezoar retrieval.

Figure 1.

Large intragastric trichobezoar at endoscopy

Figure 2.

Trichobezoar fragmentation by argon plasma coagulation

Figure 3.

Mucosal polypoid ulceration at the embedding site in the greater curvature

Figure 4.

The trichobezoar mass, completely removed after fragmentation into 10 pieces