Gastric Trichobezoar Causing Gastrointestinal Bleeding: A Case Report

Abstract

Trichobezoar is an underdiagnosed entity that has to be considered in children and adolescents, especially females, suffering from trichotillomania and trichophagia. Late diagnosis of trichobezoars showed that they cause gastrointestinal bleeding or perforation.A 17-year-old girl patient was admitted with abdominal pain and gastrointestinal bleeding. On abdominal examination, a well-defined mass in the epigastrium and the left upper quadrant was identified. Upper gastrointestinal (GI) endoscopy identified an enormous trichobezoar, which was later removed by surgery.Misdiagnosed gastric bezoars may cause life-threatening complications. Early detection for trichobezoar requires effective screening of trichotillomania. Psychiatric counseling is important to prevent bezoar recurrence.

Treatment of large gastric trichobezoar in children: Two case reports and literature review

“…They can be complicated by gastric mucosal erosion, ulceration, bleeding, perforation, gastric outlet obstruction, acute pancreatitis, obstructive jaundice, protein-losing enteropathy, and hypochromic anemia. [6–8]…”

“…They can be complicated by gastric mucosal erosion, ulceration, bleeding, perforation, gastric outlet obstruction, acute pancreatitis, obstructive jaundice, protein-losing enteropathy, and hypochromic anemia. [6][7][8] Plain abdominal radiography and upper gastrointestinal series with contrast may reveal a mottled heterogeneous mass that may be mistaken for a food-filled stomach. Abdominal CT scan demonstrates a characteristic well-defined mottled intraluminal mass containing air bubbles.…”

“…[1][2][3][4] They usually develop in young women who are emotionally disturbed, depressed, or mentally retarded, with trichotillomania and trichophagia. [5][6][7][8][9] They can lead to abdominal pain, gastric ulceration, bleeding, obstruction, and perforation. [6][7][8] Psychiatric consultation and regular follow-up after treatment are important to prevent the recurrence of trichobezoar.…”

“…[5][6][7][8][9] They can lead to abdominal pain, gastric ulceration, bleeding, obstruction, and perforation. [6][7][8] Psychiatric consultation and regular follow-up after treatment are important to prevent the recurrence of trichobezoar. We report 2 cases of a large gastric trichobezoar in children with trichotillomania and trichophagia that were successfully treated surgically.…”

Uncommon, overlooked and underreported causes of upper gastrointestinal bleeding

“…The signs include asthenia, anemia, melena, hematemesis with abdominal pain, and weight loss. Gastric bezoars can result in blockage, perforation, bleeding, and ulceration of the stomach (40). Currently, minimally invasive treatments like laparoscopic extraction or endoscopic fragmentation and removal of trichomes are the recommended options for treatment.…”