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Srpski arhiv za celokupno lekarstvo 2017 Volume 145, Issue 7-8, Pages: 403-406
https://doi.org/10.2298/SARH160630058B
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Simultaneous combined laparoscopic-endoscopic removal of a large gastric trichobezoar and gastric polypectomy

Bukarica Svetlana (Institute for Children and Youth Health Care of Vojvodina, Clinic for pediatric surgery, Novi Sad + Faculty of Medicine, Novi Sad)
Jokić Radoica ORCID iD icon (Institute for Children and Youth Health Care of Vojvodina, Clinic for pediatric surgery, Novi Sad + Faculty of Medicine, Novi Sad)
Antić Jelena (Institute for Children and Youth Health Care of Vojvodina, Clinic for pediatric surgery, Novi Sad + Faculty of Medicine, Novi Sad)
Stojšić Mirjana ORCID iD icon (Institute for Children and Youth Health Care of Vojvodina, Department of Pediatrics, Novi Sad)
Komarčević Aleksandar (Institute for Children and Youth Health Care of Vojvodina, Clinic for pediatric surgery, Novi Sad + Faculty of Medicine, Novi Sad)
Fratrić Ivana ORCID iD icon (Institute for Children and Youth Health Care of Vojvodina, Clinic for pediatric surgery, Novi Sad + Faculty of Medicine, Novi Sad)

Introduction. Trichobezoars and gastric polyps are very rare conditions in children and may pose a diagnostic and therapeutic challenge. The purpose of this work is to present our successful experience using combined laparoscopic-endoscopic procedure for simultaneous treatment of a trichobezoar and gastric polyp in the same patient. Case outline. We present an unusual case of a 15-year-old girl whose symptoms included abdominal pain, non-bilious vomiting after feeding, including undigested food and sometimes hair. Positive history of trichophagia indicated that a trichobezoar could be the reason for her problems. Endoscopy and ultrasound examination revealed a trichobezoar occupying almost the entire capacity of the stomach, as well as one oval polyp in the prepyloric area of the antrum. Simultaneous combined laparoscopicendoscopic rendezvous procedure was performed. The trichobezoar (14 × 6 cm) and the gastric polyp (2.2 × 1.7 cm) were completely removed laparoscopically through anterior gastrotomy, with great support of an adequate endobag and mechanical fragmentation of trichobezoar. The postoperative course was uneventful. Conclusion. This case shows that diagnostic endoscopy is valuable and that the combined laparoscopicendoscopic technique is feasible, safe and recommended treatment for simultaneous removal of a gastric trichobezoar and gastric polypectomy.

Keywords: trichobezoar, gastric polyp, laparoscopy, endoscopy