PMC5279109_01
Gastric bezoar on ultrasonography. Gray-scale abdominal ultrasonography reveals an arc-shaped intraluminal mass (blue arrow) with a strong posterior acoustic shadow (yellow arrows).
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F1
Abdominal ultrasonography revealed an arc-shaped, mobile, irregular, coherent, intraluminal mass with a strong acoustic shadow, 10.5 cm in its longest dimension, consistent with a gastric bezoar (Fig. 1). This child's clinical course is summarized in the Supplemental Time-line (see Supplemental Fig. 1, Supplemental Content, which illustrates the clinical course of the child described in this case report).
Endoscopic therapy. (A): Gastric trichophytobezoar at the first endoscopic treatment. (B) Some hair and nondigestible food fibers are retrieved during the initial endoscopy. (C) The gastric trichophytobezoar has loosened 5 days after initial treatment. (D) The trichophytobezoar is completely removed during the second endoscopy.
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F2
The endoscopic examination revealed a large intragastric trichophytobezoar approximately 10.5 cm x 3.5 cm in size, with extension of a few hairs through the pylorus (Fig. 2A). Some of the hair and nondigestible food fibers were retrieved with grasping forceps (Fig. 2B). Gastroscopy revealed that the gastric trichophytobezoar was significantly looser than it had been previously (Fig. 2C). The remaining trichophytobezoar was completely endoscopically retrieved through the pylorus in under an hour (Fig. 2D).
Nothing is present in the stomach at the third endoscopic examination.
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F3
Five days later, a third endoscopic examination revealed no remaining material in the stomach (Fig. 3).