trichobezoar is a condition in which the pateint has a tendency to eat his/her own hair. For details https://drnitinjha.com/

1. “LAPAROSCOPIC MANAGEMENT
OF TRICHOBEZOAR”.
IS IT FEASIBLE?
Dr.Nitin Jha
Dr.Yogesh Agarwala, Dr.Sudhir Sharma,
Dr.Manish Gupta, Dr.Akshaya Panda, Dr.M.Shekhar Sharma,
Dr Ashutosh Tandon Dr. Ramandeep Singh
FORTIS HOSPITAL, NOIDA

2. OUR EXPERIENCE
 2 CASES
 Age= 16 and 19 Years
 Females
 Complaints=
* Recurrent pain in abdomen
* Vomiting

3. INVESTIGATIONS

4. MANAGEMENT
 Laparoscopic gastrotomy and evacuation
 3 ports used
 Standard technique for pneumoperitoneum

7. RESULTS
 OPERATING TIME= 2 hours 10 min in case I
and 3 hours in case II.
 IMMEDIATE COMPLICATIONS= None.
 Late= small collection in both the cases at the
extraction port site, managed by
aspiration/drainage and antibiotics.
 Cosmetic results were excellent.

8. CONCLUSION
 Laparoscopic management is feasible and
safe with minimal morbidity

9. REVIEW OF LITERATURE
 Bezoar = concretion of foreign material in the
stomach and intestine
 3 types---Tricho
---Phyto
---chemical concretions
 Rapunzel Syndrome

11.  Incidence
Age--- 80% cases are <30 years
Sex---90 % are females
* (De Bakey et all ,Surgery)
 Etiology
Trichophagy
10% are mentally deranged

12.  Clinical features
--Pain in abdomen
--Loss of weight
--Vomiting
--Mobile epigastric mass
 Investigations
Xray abdomen,Ba meal ,U G I Scopy

13. Complications
 Ulceration and upper GI bleed
(Tricho=6%,Phyto 15 %)
 Perforation
 Intestinal obstruction
(Tricho 10 %,Phyto 25 %)

14. MANAGEMENT
 SMALL size
1) LASER based endoscopic lithotripsy
device (* Huang et all,Chin Med J
Surg,1990)
2) Enzyme Cellulase—for phyto.
(*Lee et all,BJS,1997)
3) Endoscopic Fragmentation

15.  LARGER size
1) Gastrotomy —Lap/open
Search for detached pieces in rest of
the GI tract
2) ESWL (* Benes et all, Endoscopy,2001)

16. THANKS