Point-of-care gastric ultrasound in trichobezoar: case report


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Abstract

Introduction:Trichobezoar is a rare entity that consists of a mass of hair particles in the gastrointestinal tract. The treatment of trichobezoar is basically surgical; however, alterations in gastric emptying represent a challenge for anesthesia because of the risk of bronchoaspiration during induction. Ultrasonography as a perioperative tool is helpful to guide decision-making and to plan the anesthetic technique to evaluate the gastric contents.Clinical findings, diagnostic evaluation, and interventions:This is a case of an emergent surgical correction due to trichobezoar. The ultrasound findings of the gastric evaluation allowed for the identification of a patient at risk of regurgitation and guided the decision about the induction of anesthesia.Conclusion:Currently, the opinion of the anesthesiologist based on the medical record and the physical examination determines the approach to the induction of anesthesia. The qualitative evaluation of the gastric contents using ultrasound, in addition to the physical examination, is extremely useful in case of a surgical emergency or in the absence of more sophisticated diagnostic images, when suspecting conditions with a full stomach and high risk of bronchoaspiration.

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