استئصال شعر من معدة فتاة عمرها 18 سنة(bezoar)

محمد عثمان عبدالله · #1 24-08-2010, 09:59 PM

السلام عليكم ورحمة الله وبركاته وبعد.......
اعرض عليكم هذه الحالة الغريبة جداااااا والتي اتت الينا في المستشفى وقد قمنا بنشرها في ال احد المجلات العلمية المشهورة وهي استئصال شعر من معدة فتاة تبلغ من العمر 18 عاما.
لا اريد الاطالة عليكم وسأقوم بالدخول مباشرة في الموضوع مرفقا لكم صورة لما وجدنا داخل غرفة العملية....
ye18ars old female admited to our hospital coplaining of prolonged vomiting in the last year.
H.P.I:hte condition started one years ago with recurrent attack vomiing. in the first six months of that duration the vomiting occuring once every weak containing undigested food particles.After 6 months the frequency of vomiting increase to 4 times every weak to continue with this frequency up to next 6 months and during this period she was hospitalized and recived antimalarial ,aniemitics and I.V fluids.2 weaks prior to admission she was vomit blood small in amount and contain undigestrd food particles that ass with heart burn,no dysphagia,no abdominal pain,no constipation ,no diarrhea,no melena ,and no jaundice.

On Examination:-
pt looks un well ,sunken eye,cachexic,pale,but not jaundiced or cyanosed.
also looks sychotic.
abdominal examination and other system are normal.

Investigation:Hb 64%
TWBC:normal
malaria:negative
upper GIT endoscopy :-esophagus normal,
stomach:show hair which prevent endoscope to pass easly through it and there is mild gastric erosions and this hair found in all part of the stomach and extended to the 1st part of the duodenum
after endoscopy we ask the father of this pt was she eat hair....and the answer yes.
she was eat hur hair from age of 5 years.
After that we reach to diagnosis of trichobezoar .

TREATMENT:surgery >>>>laprotomy was done,supraumblical midline incision is made,the abdomen was open in layer and gastrotomy was done,and the surgon compress by to hand hand one abve the fundus and and another below the 1st part of the duodenum and make perssure in opposite direction between to hand then hair is removed smoothly as one whole.
the pt discharged after one weak to home in very healthy state and follow up every weak in reffer clinic of surgery
عذرا اخواني سأحاول ادراج الصورة قريبا..........................