Cows-feet soup: a rare cause of recurrent trichobezoar

Abstract

SummaryA 45-year-old Afro-Caribbean woman attended the emergency department with worsening dysphagia, abdominal distension, abdominal pain, shortness of breath and generalised weakness. She enjoyed preparing and eating cows-feet stew and preferred to cook the meat with the hair and skin intact. On admission she had a severe microcytic anaemia and was malnourished. Abdominal x-ray and CT revealed a large gastric bezoar. At gastrotomy a foul-smelling 2.42 kg mass of hair, leathery skin and altered food were evacuated from the lesser curvature of the stomach. She had undergone the same procedure 8 years earlier to remove a similar trichobezoar.Following psychiatric review it was deemed that the patient had no underlying psychiatric condition and had full insight into why her trichobezoar had re-occurred. She made a good postoperative recovery and stopped eating cows-feet stew. BACKGROUND

Recurrent trichobezoar in a patient with Rapunzel syndrome

“…Without efficient treatment of trichophagia, recurrences may occur. Only few cases of recurrent trichobezoars have been reported in the literature; they mostly concern adult patients (2)(3)(4) . The treatment of a bezoar producing acute symptoms is usually surgical via laparotomy and gastrotomy.…”

Upper Gastrointestinal Manifestation of Bezoars and the Etiological Factors: A Literature Review

“…In this condition, patients have significant psychological or behavioral abnormalities most commonly found in females and can be associated with trichotillomania and trichotillophagia (urge to pullout one's own hair) combined with trichophagia [2, 17]. Rarely, recurrent trichobezoar may link with animals' feet stew with skin and hair intact [15]. Gastric bezoars with anorexia nervosa, bulimia nervosa [16–18], and sickle cell disease [19] have also been reported in this entity.…”

Large-Scale Brain Simulation and Disorders of Consciousness. Mapping Technical and Conceptual Issues

“…Narrowly, computer simulation can be described as the use of a computer to solve an analytically unsolvable equation ( Humphreys, 2009 ; Frigg and Reiss, 2009 ; Winsberg, 2009 ). Broadly, computer simulation can be equated to the entire process of developing, using and justifying a model that involves mathematics that is not analytically tractable ( Frigg and Reiss, 2009 ).…”

“…Narrowly, computer simulation can be described as the use of a computer to solve an analytically unsolvable equation ( Humphreys, 2009 ; Frigg and Reiss, 2009 ; Winsberg, 2009 ). Broadly, computer simulation can be equated to the entire process of developing, using and justifying a model that involves mathematics that is not analytically tractable ( Frigg and Reiss, 2009 ). Three main features of computer simulations so defined emerge ( Winsberg, 2009 ; Serban, 2017 ): they depend on particular implementation constrains; they rely on particular theoretical models; they play a justificatory role in drawing inferences about the target-object.…”