Gastric trichobezoar presenting as gastric outlet obstruction--a case report.

Trichobezoars are impactions of swallowed hairs in the stomach and occasionally in the intestine. They occur in emotionally disturbed, depressed, or mentally retarded patients who have trichotillomania and trichophagia. Removal of gastric trichobezoar by open surgery (gastrotomy) is a standard approach. Psychiatric follow-up is needed to diminish the recurrence of trichotillomania and trichophagia. Here, we report a case of large gastric trichobezoar presenting as gastric outlet obstruction in a 13-years-old girl. She was treated with open surgical extraction of the bezoar and behavioral therapy.

The observation of response to cardiovascular system at periextubation period after continuous epidural anesthesia combined with general anesthesia.

The observation of cardiovascular response at peri-extubation period after continuous epidural anesthesia combined with mild general anesthesia was studied. Fifty patients of carcinoma esophagus were randomly divided into two groups, general anesthesia + epidural anesthesia combined group and control group (only general anesthesia), each 25 cases in one group, using a multifunctional monitor, continuous monitoring and recording was done for ECG, systolic pressure (SP), diastolic pressure (DP), heart rate (HR), oxygen saturation (Spo2) and rhythm of heart during the peri-extubation period. Severe cardiovascular instability was detected in control group during peri-extubation period, especially at the time of extubation, even higher than the baseline values (p<0.05). In combined group, the cardiovascular instability was far less, only a slight increase was noted at the time of extubation (p>0.05). The use of halothane was far less in combined group than that in control group (p<0.05). Mild general anesthesia combined with continuous epidural anesthesia is a good modality of anesthesia that can obviously decreased cardiovascular instability during peri-extubation.