Trichobezoar presenting as a gastric outlet obstruction: A case report

Nwankwo, Eugene; Daniele, Edward; Woller, Erin; Fitzwater, John; McGill, Thomas E.; Brooks, Steven E.

doi:10.1016/j.ijscr.2017.03.011

Cited by 16 publications

(18 citation statements)

References 15 publications

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“…These strands initially are enmeshed which creates a mass in the shape of stomach. 8 The stomach is not able to exteriorize this out of the lumen because of smooth surface of hair and peristalsis is not sufficient for propulsion. Vaughen ED et al, described the term Rapunzel syndrome as trichobezoars extending continuously through the entire length of the small intestine as a tail.…”

Section: Discussionmentioning

confidence: 99%

Trichobezoars as a cause of intestinal obstruction in a young female

2019

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A bezoar is a mass found trapped in the gastrointestinal system, though it can occur in other locations. There are various types of bezoars including food boluses, lactobezoar, pharmacobezoar, phytobezoar, diospyrobezoar and trichobezoar. They are common in children and adolescents, and 90% of the patients are women. Complications may manifest as gastric outlet obstruction or bleeding and intestinal obstruction. CT is the preferred image modality for the evaluation of suspected trichobezoars in order to characterize the size, location, presence and level of obstruction and complications such as ischemia or perforation. Here authors present a case to stress the importance of considering trichobezoars as one of the causes for intestinal obstruction in young females.

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Section: Discussionmentioning

confidence: 99%

Trichobezoars as a cause of intestinal obstruction in a young female

2019

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“…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 ].…”

Section: Discussionmentioning

confidence: 99%

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

García-Ramírez

Nuño-Guzmán

Zaragoza-Carrillo

et al. 2018

Case Rep Gastroenterol

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Bezoars are conglomerations of undigested foreign material retained in the gastrointestinal tract. Trichobezoar is a compact conglomeration of swallowed hair and constitutes less than 6% of all bezoars. Their most frequent location is in the stomach but they may extend through the pylorus into the small bowel. This condition is known as Rapunzel syndrome. Many patients may remain asymptomatic or present a mild form of the disease characterized by abdominal pain, early satiety, nausea, and vomiting. Complications may manifest as gastric outlet obstruction or bleeding, and intestinal obstruction. A 15-year-old female patient presented with clinical findings of intestinal obstruction. The patient suffered from depressive and anxiety disorders and trichotillomania, although trichophagy could not be assured. Alopecia circumscripta and irregular hair length on the scalp were identified. A computed tomography (CT) scan showed two images highly suggestive of trichobezoars, one in the stomach and the second one causing obstruction at the ileocecal valve. At laparotomy, both a mobile gastric trichobezoar with a tail extending to the duodenum and a trichobezoar causing obstruction at the ileocecal valve were removed. The postoperative course was uneventful. The passage of a detached trichobezoar fragment in a patient with Rapunzel syndrome may cause intestinal obstruction. CT is the preferred image modality for the evaluation of suspected trichobezoars in order to characterize their size and locations, the presence and level of obstruction, and complications such as ischemia or perforation. A case of small-bowel obstruction secondary to ileal trichobezoar in a patient with Rapunzel syndrome is herein reported.

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“…The treatment approach depends on the size, location and the complications of the trichobezoar followed by post treatment prophylaxis against further bezoar formation by the patient. Many complications are associated with a large eroding or obstructing trichobezoar which includes gastric ulceration /perforation /emphysema, obstructive jaundice /cholangitis, acute pancreatitis, intestinal intussusception, appendicitis, nephrotic syndrome and other malabsorption related complications like protein-losing enteropathy, iron deficiency, and megaloblastic anemia [46][47][48][49].…”

Section: Discussionmentioning

confidence: 99%

Giant Trichobezoar: A Rare Cause of Gastric Outlet Obstruction

Sharma¹

2018

IJSST

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Bezoars are uncommon conglomerates made up of foreign bodies like vegetable fibers, hair, inspissated/formula milk, semi-fluid medications or pills etc. in the alimentary tract of humans and certain animals. These elements remain undigested by the gastric fluids resulting in their accumulation within the gastrointestinal tract, most commonly the stomach and proximal portions of the small bowel. Presented here is an unusual case of giant trichobezoar due to trichophagia in the absence of trichotillomania in a 16-year-old girl who presented with a palpable epigastric mass along with symptoms of gastric outlet obstruction.

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Trichobezoar presenting as a gastric outlet obstruction: A case report

Cited by 16 publications

References 15 publications

Trichobezoars as a cause of intestinal obstruction in a young female

Trichobezoars as a cause of intestinal obstruction in a young female

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

Giant Trichobezoar: A Rare Cause of Gastric Outlet Obstruction

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