Trichobezoar – A Rare Cause of Abdominal Mass and Gastric Outlet Obstruction

Abstract

The authors present the clinical case of a 14-year old girl with weight loss, anorexia, epigastric abdominal pain and postprandial vomiting with 5 months duration. There was a background of trichophagia for 2 years without evidence of alopecia or psychiatric history. The physical examination revealed an epigastric mass motionless, stony, with poorly defined limits, painful on palpation and about 7 cm diameter. Abdominal ultrasonography showed thickening of the gastric wall and antrum with gastric distension. The abdominal tomography scan and endoscopic examination revealed the presence of a bulky trichobezoar occupying almost the entire gastric lumen. It was decided to undergo gastrotomy and extraction of the bezoar. The postoperative period was uneventful.

Small-Bowel Obstruction Secondary to Ileal Trichobezoar in a Patient with Rapunzel Syndrome

“…Gastric erosion and ulceration may lead to bleeding or perforation. A large trichobezoar may lead to gastric outlet obstruction [ 8 , 9 ]. Intestinal obstruction in the terminal ileum is uncommon and may cause ischemia and perforation [ 10 , 11 ].…”

Trichobezoar-Induced Heartburn in a Teenage Girl: A Case Report

“…It is a rare medical condition with clinicians encountering it around 0.3% of performed upper gastrointestinal endoscopies. 1 …”

“…Hair proteins get denatured by gastric acid and become oxidized, which in turn causes the change of hair color to black, regardless of the original hair color. 1 , 8 Eventually, bezoars will grow with the accumulation of food, especially cellulose-rich foods and other indigestible materials, and form a conglomerate of various materials. Bacteria may colonize this collection resulting in halitosis.…”

“…Bezoars are termed trichobezoar when they are composed of hair. 1 The word trichobezoar originates from the word “bazahr” used by Arab medical writers to describe poison antidotes extracted from an animal’s abdomen, and the Greek word for hair, “trich.” The condition is often associated with trichotillomania (obsessive hair pulling) and/or trichophagia (hair swallowing). Bezoars are a rare cause of abdominal pain and other unspecific abdominal complaints such as heartburn, constipation, and anorexia.…”

Tricobezoar gastroduodenal en la edad escolar. Caso clínico

“…3 Los materiales que componen los bezoares comprenden material vegetal (fitobezoar), que es el tipo más común de bezoares; restos de frutas (diospirobezoares), que es el subtipo de fitobezoar más común; cabello (tricobezoar) y medicamentos ingeridos (farmacobezoar). 4 Las personas con riesgo de desarrollar esta patología son aquellas con alteraciones anatómicas o en la motilidad gastrointestinal, como pacientes diabéticos, con patologías neurológicas, alteraciones en la secreción de jugo gástrico o con cirugías gástricas previas. 5 Las enfermedades psiquiátricas y el retardo mental se asocian con los bezoares, debido a la pica y a la ingesta compulsiva y excesiva de comida.…”