Gastric Outlet Obstruction and Iron Deficiency Anemia Secondary to Gastric Bezoar: A Case Report

Abstract

Trichobezoars are an accumulation of undigested hair in the gastrointestinal system. They are a rare finding and are more likely in young females. Diagnosis is largely dependent on history taking and imaging, and treatment involves the removal and psychiatric evaluation.We describe the case of a 21-year-old female with a history of gastroesophageal reflux disease (GERD) who presented with abdominal pain. Imaging showed a distended stomach with a suspected swallowed foreign substance. The patient subsequently underwent midline laparotomy, gastrotomy, and bezoar extraction. Postoperatively the patient was found to have trichotillomania, trichophagia, anxiety, depression, and symptomatic anemia. Initial management of gastric bezoars includes proper removal, but the additional follow-up needs to include psychiatric evaluation and treatment to prevent reoccurrence. It is also imperative to assess and treat underlying nutritional deficiencies.

A plastic bezoar causing bowel obstruction: A case of table cover ingestion

“…Bezoars rarely occur, but cases have been well documented [ 6 , 7 ]. The literature review revealed that most of the cases of ingestion of blunt foreign bodies occur in mentally challenged individuals, prisoners and those diagnosed with psychiatric illnesses [ 5 , 8 , 9 , 11 ]. The impaction of these materials often occurs in narrow areas such as the lower esophagus, duodenum, ileocecal valve or even the anus [ 8 , 10 ].…”

Respiratory and intestinal trichobezoar in a female: An unusual case report and literature review

“…Therapeutic options can include endoscopic removal, laparoscopic removal, and gastrotomy. 3 In this case report, we present the clinical course of a young woman with underlying psychological issues who presented with hair in both her respiratory and gastrointestinal systems. The trichobezoar initially presented as a mucus plaque, but its true nature was later revealed.…”

“…Management strategies primarily depend on the size, location, and type of bezoar. Therapeutic options can include endoscopic removal, laparoscopic removal, and gastrotomy 3 …”

“…2 While other types of bezoars like phytobezoars (vegetable) and pharmacobezoars (undigested medication) exist, trichobezoar is the most frequently encountered form. 1,3 Although trichobezoars are commonly observed within the gastrointestinal (GI) tract, they can also occur in the respiratory system. 1,4 Patients with GI trichobezoars may present a diverse range of clinical complications, such as chronic abdominal pain, gastric outlet obstruction, nausea, vomiting, weight loss, malnutrition, food intolerance, diarrhoea and constipation.…”

“…The term ‘tricho’ originates from Greek, meaning hair, while ‘bezoar’ is derived from the Persian word ‘pādzahr’, translating to antidote, reflecting ancient beliefs about them 2 . While other types of bezoars like phytobezoars (vegetable) and pharmacobezoars (undigested medication) exist, trichobezoar is the most frequently encountered form 1,3 …”