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

Abstract

Rationale: Gastric trichobezoars are a rare form of bezoar formed from swallowed human hair as well as hair from dolls or animals, blankets, and carpets. They usually develop in young women who are emotionally disturbed, depressed, or mentally retarded, with trichotillomania and trichophagia. They can lead to abdominal pain, gastric ulceration, bleeding, obstruction, and perforation. Patient concerns: A 13-year-old girl was admitted to our institution with complaints of nausea, vomiting, and epigastric pain for 2 days. She underwent laparoscopic removal of a large gastric trichobezoar at our institution 5 years ago. A 12-year-old girl presented at our institution due to epigastric pain, dizziness, and melena for 2 days. Diagnosis: They were diagnosed with gastric trichobezoar by abdominal computed tomography scan and upper gastrointestinal endoscopy. Interventions: Large gastric trichobezoars were removed via a mini-laparotomy. Outcomes: They recovered well postoperatively without complication. Lessons: Although the recurrence of gastric trichobezoar after surgery is rare, few recurrent cases were reported in the literature. Therefore, psychiatric consultation and regular follow-up after treatment should be considered in the children and their parents to prevent the recurrence of gastric trichobezoar.

Indigestible Trichobezoar Mimicking Inflammatory Bowel Disease: A Case Report and a Literature Review

“…Trichobezoars are associated with underlying psychiatric disorders and are common in young female adolescents in the second decade of life, as our patient, between 13 and 20 years of age [9,10]. The most common psychiatric comorbidities are emotional disturbances, pica, obsessive compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), depression, and anorexia nervosa [11,12].…”

“…Contrast-enhanced computed tomography (CT) is a superior radiological investigation showing high sensitivity (up to 90%) and specificity (up to 60%) in the identification of a trichobezoar and definition of its extension, which is a characteristic well-defined mottled intraluminal mass containing air [1,11,25]. A CT scan may evidentiate the presence of multiple lesions, clarify differential diagnosis with other causes of intestinal obstruction, and evaluate the conditions of the intestinal loops.…”