Gastric trichobezoar: An uncommon cause of epigastric pain: A case report

Daoud, Rahma; Tlili, Ahmed; Fendri, Sami; Akrout, Amira; Trigui, Aymen; Boujelbène, Salah

doi:10.1002/ccr3.5653

Cited by 4 publications

(12 citation statements)

References 14 publications

(60 reference statements)

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“…Trichobezoars rarely occur in everyday clinical work. They were discovered in 1779 during an autopsy of a patient who died of gastric perforation [10]. Nowadays, they are described in the surgical literature, and fewer cases are found in psychiatric sources [14].…”

Section: Discussionmentioning

confidence: 99%

Trichobezoar Found Accidently while Diagnosing Resistance to Thyroid Hormone

Szopińska,

Tracz,

Malczyk

et al. 2024

Case Rep Gastroenterol

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Introduction: Bezoars are masses of indigestible foreign material in the gastrointestinal tract, usually in the stomach. These materials could be indigestible fruits, hair, milk products, or tablets. In children, the most common type of bezoar is trichobezoar (formed from hair). Case Presentation: We describe a female patient who has been complaining about deterioration of mood, collapse without losing consciousness, scotomas, and cardiac arrhythmia for 2 years. Based on the results of thyroid hormone, resistance to thyroid hormone (RTH) was suspected. Physical examination during hospitalization revealed a palpable upper abdominal mass. Several diagnostic examinations were performed. The abdominal ultrasound showed acoustic shadowing caused by a pathological structure in the upper abdomen. Therefore, the contrast X-ray of the digestive tract revealed a deficit of contrast with an irregular shape in the stomach body and the pylorus region. Due to these results, a gastroscopy was performed, which revealed a large trichobezoar of the stomach. The trichobezoar was surgically removed without complications. Conclusion: The case presented shows that these nonspecific symptoms and laboratory test suggesting RTH require multi-path diagnostics and the cooperation of many specialists, ultimately giving a surprising diagnosis. It is crucial to interpret diagnostic examinations with regard to the patient’s physical condition. Diagnosis of trichobezoar requires a detailed search of causes to avoid another incident.

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Section: Discussionmentioning

confidence: 99%

Trichobezoar Found Accidently while Diagnosing Resistance to Thyroid Hormone

Szopińska,

Tracz,

Malczyk

et al. 2024

Case Rep Gastroenterol

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“…[ 7 ] Although TTM and TPH are frequently encountered in trichobezoar patients with clinical symptoms,[ 8 ] the incidence of gastric trichobezoars is around 0.5% in TTM and TPH patient groups. [ 9 ] Although the ingestion of indigestible foreign objects such as hair, nails, and plastic is relatively common in society, low-frequency states of the disease do not constitute a clinical manifestation, and continued ingestion behavior in some patients may present with fatal complications. [ 9 ] There is no information on how much time and how much hair it takes for TPH to transform into a symptomatic trichobezoar.…”

Section: Discussionmentioning

confidence: 99%

“…[ 9 ] Although the ingestion of indigestible foreign objects such as hair, nails, and plastic is relatively common in society, low-frequency states of the disease do not constitute a clinical manifestation, and continued ingestion behavior in some patients may present with fatal complications. [ 9 ] There is no information on how much time and how much hair it takes for TPH to transform into a symptomatic trichobezoar. In our series, rapunzel syndrome was encountered in one of our patients who was the same age and had hair ingestion habit for 3 years, while gastric bezoar and satellite ileal bezoar were encountered in the other.…”

Section: Discussionmentioning

confidence: 99%

A rare cause of intestinal obstruction in children trichobezoar: How to diagnose?

Kaba

2023

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Trichobezoar is a rare clinical condition in children, which is caused by the accumulation of swallowed hair mass in the digestive tract. This condition is most common in young women with psychiatric histories who suffer from trichotillomania (TTM), where they have an irresistible urge to pull out their hair. Diagnosis and treatment of this pathology, which is already extremely rare, and its variable clinical presentations are challenging. The aim of this study was to increase awareness of trichobezoar in the differential diagnosis of signs of intestinal obstruction in children and to evaluate the diagnosis and management of this rare pathology. METHODS: The clinical data of six patients who were treated for trichobezoars in the pediatric surgery department of our hospital between 2009 and 2022 were retrospectively analyzed. RESULTS: Six female patients were treated with the diagnosis of trichobezoar during this period. Patients were diagnosed with the help of anamnesis, physical examination, abdominal ultrasonography (USG), and finally, endoscopy. USG can predict the intestinal wall infiltration and the tail extended to the duodenum through pylorus in the series. All patients were evaluated with contrast-enhanced abdominal radiography. Five surgical interventions were performed in four of the cases. In a case who underwent surgery twice, the distal intestinal satellite bezoar was not noticed in the first operation. Two patients were diagnosed to have trichobezoar, but surgery was not required. These patients were younger and had early-onset TTM (before 10 years old). The patients were followed for an average of 10.8 years and no recurrence was detected. CONCLUSION: Trichobezoar is a rare cause of intestinal obstruction in children with fatal complications when diagnosed late. Failure to follow an algorithm for the management of the disease causes difficulties in the diagnosis and treatment. Especially in patients with a known psychiatric history, whole abdominal USG and laparoscopy performed with awareness can prevent unnecessary examinations.

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“…However, there are no precise statistical data on the incidence of gastric trichobezoar in this risk group. In general, it is estimated that the incidence of trichobezoar is around 0.5 % [3] , [4] . The manifestations caused will be related to the location and extension of the trichobezoar, so they are unspecific, giving great relevance to the psychiatric history as a plausible risk factor [2] , [4] .…”

Section: Introductionmentioning

confidence: 99%

“…However, another point to highlight is the fact that in the absence of psychiatric history and lack of information, the surgical diagnosis can identify psychological or psychiatric factors not previously investigated, which can definitively solve the primary cause, preventing the recurrence of trichobezoar in the future. Case reports and case series have reported that trichophagia is a behavior that is strongly associated with trichotillomania [2] , [3] , [4] , [5] . However, involuntary nocturnal trichotillomania is more complex to diagnose and treat, and may be referred almost exclusively by an observant family member.…”

Section: Introductionmentioning

confidence: 99%