A Case Report: Usefulness of a Smart Retractor Inserted into the Stomach for Removing a Giant Gastric Trichobezoar in an Adult

Abstract

A 37–year–old woman was admitted to our hospital because of abdominal distention and epigastralgia. Blood tests revealed severe anemia (Hb 4.6g/dL). Abdominal computed tomography showed a dilated stomach stuffed with an air–containing mass. Upper gastrointestinal endoscopy revealed a large trichobezoar in the stomach which could not be removed with the endoscope. Thus, laparotomy was performed using a smart retractor inserted into the stomach through the abdominal wall. We could remove the trichobezoar without dividing it. Only 12 adult cases of trichobezoar have been reported in Japan, and this is the first case in which a wound protector was used for removal. A smart retractor hooked into the stomach is useful for minimizing the incision and preventing spillage of gastric contents.