Trichophagia and Trichobezoar: Case Report

Abstract

Objective:Trichobezoar consists of a compact mass of hair occupying the gastric cavity to a various extent. When the trichobezoar extends past the duodenum it is better referred to as Rapunzel Syndrome. Although trichobezoars are well described in terms of surgical diagnostic and procedure, there are only but very scarce reports on psychiatric literature, usually associated with trichotillomania. The authors present a clinical case of trichobezoar and discuss the most relevant aspects concerning this entity.Methods:Presentation of psychiatric and surgical data concerning the case report. Previously reported cases are also mentioned.Results:Report of a 27-year-old female patient with a trichobezoar submitted to surgical removal, with a prior intervention 4 years before also due to trichobezoar, and with unknown psychiatric antecedents or follow-up.Conclusions:A trichobezoar represents a serious surgical condition. It is important to consider such diagnosis in face of suggestive symptoms, even if signs of trichotillomania are not present. The discrepancies between the prevalence of trichotillomania and trichobezoars due to trichophagia may be due to issues related to self-selection of patients and symptom severity. Such issues may also be important in the study of impulsive-compulsive spectrum models and to their relevance to impulse control disorders.

Evaluation of acute intestinal obstruction cases due to gastrointestinal bezoars: 5-year-experience

“…Bahsi geçen predispozan faktörler genellikle fitobezoar oluşumu sıklığını arttırmaktadır 4 . Trikobezoar oluşumunun altında ise sıklıkla trikofaji yatmaktadır ve hastalarda genellikle psikiyatrik problemler bulunmaktadır 10,23,24 . Bu nedenle fitobezoarlar daha sık görülmektedir ve neredeyse tüm bezoar tiplerinin yarısını fitobezoarlar oluşturmaktadır Bezoarlar, intestinal obstrüksiyonun dışında, karın ağ-rısı, bulantı, kusma, kilo kaybı, gastrointestinal sistem kanaması ve mide perforasyonu gibi klinik bulgular verse de azımsanmayacak bir kısmı asemptomatik seyretmektedir.…”

Trichobezoar in the absence of trichotillomania: a consequence of occupational hazard

“…8 Trichophagia and trichobezoar are abundantly described in surgical literature. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] In majority of the literature trichotillomania and trichophagia has coexisted with trichobezoar.…”

“…9 In few cases, no evidence of trichotillomania was found in patients presenting with trichobezoar. 10,11 Trichobezoar should be considered as a differential diagnosis in young females who present with non-specific symptoms such as epigastric pain, fatigue, weight loss and epigastric mass.…”

Unusual trichobezoar of the stomach and the intestine: a case report

“…The lack of reports on endoscopic treatment might partly be explained by the rarity of trichobezoars, but it could also indicate that laparoscopy is not an attractive treatment modality for trichobezoar. Of the six case reports, two reported failure to remove the trichobezoar, which was attributed to the large size of the trichobezoar and to the presence of satellite trichobezoars in other locations of the gastrointestinal tract (as in our patient) [13,14]. In one study, endoscopic and laparoscopic approaches were combined; because endoscopic fragmentation of the bezoar was not possible, a laparoscopic approach was used to fragment the trichobezoar, then endoscopy used to remove the fragments [19].…”