Huge gastric trichobezoar caused by involuntary nocturnal trichophagia and trichotillomania in a female adolescent

López-Álvarez, Lina María; Moreno-Castellanos, Milena Andrea; Álvarez-Acuña, Ana Milena; Echeverri-Mejía, Camila; Narvaez‐Rojas, Alexis Rafael; Lozada-Martínez, Iván David

doi:10.1016/j.ijscr.2022.107627

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…This condition, called nocturnal TTM, has been reported in the literature as a pathology that rarely causes bezoars. [11] The admission clinics of the four patients in our series who underwent surgery were similar. In other series in the literature, the presentation of the patients depended on the size and location of the trichobezoar and the length of stay in the intestinal tract.…”

Section: Discussionmentioning

confidence: 61%

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A rare cause of intestinal obstruction in children trichobezoar: How to diagnose?

Kaba

2023

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Trichobezoar is a rare clinical condition in children, which is caused by the accumulation of swallowed hair mass in the digestive tract. This condition is most common in young women with psychiatric histories who suffer from trichotillomania (TTM), where they have an irresistible urge to pull out their hair. Diagnosis and treatment of this pathology, which is already extremely rare, and its variable clinical presentations are challenging. The aim of this study was to increase awareness of trichobezoar in the differential diagnosis of signs of intestinal obstruction in children and to evaluate the diagnosis and management of this rare pathology. METHODS: The clinical data of six patients who were treated for trichobezoars in the pediatric surgery department of our hospital between 2009 and 2022 were retrospectively analyzed. RESULTS: Six female patients were treated with the diagnosis of trichobezoar during this period. Patients were diagnosed with the help of anamnesis, physical examination, abdominal ultrasonography (USG), and finally, endoscopy. USG can predict the intestinal wall infiltration and the tail extended to the duodenum through pylorus in the series. All patients were evaluated with contrast-enhanced abdominal radiography. Five surgical interventions were performed in four of the cases. In a case who underwent surgery twice, the distal intestinal satellite bezoar was not noticed in the first operation. Two patients were diagnosed to have trichobezoar, but surgery was not required. These patients were younger and had early-onset TTM (before 10 years old). The patients were followed for an average of 10.8 years and no recurrence was detected. CONCLUSION: Trichobezoar is a rare cause of intestinal obstruction in children with fatal complications when diagnosed late. Failure to follow an algorithm for the management of the disease causes difficulties in the diagnosis and treatment. Especially in patients with a known psychiatric history, whole abdominal USG and laparoscopy performed with awareness can prevent unnecessary examinations.

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Section: Discussionmentioning

confidence: 61%

“…This condition, called nocturnal TTM, has been reported in the literature as a pathology that rarely causes bezoars. [ 11 ]…”

Section: Discussionmentioning

confidence: 99%

A rare cause of intestinal obstruction in children trichobezoar: How to diagnose?

Kaba

2023

Ulus Travma Acil Cerrahi Derg

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“…Trichobezoar mainly affects young women with psychiatric antecedents who suffer from trichotillomania or trichophagia. It is a rare pathological entity that can seriously compromise the affected person's integrity, quality of life, functional capacity, and energy [2].…”

Section: Discussionmentioning

confidence: 99%

Huge gastric trichobezoar in school-aged girl: A Case Report

2023

J Med Case Rep Case Ser

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Case observationWe report a case of a 15-year-old girl who presented initially to a private clinic at Kenitra City in the north-west of Morocco, brought by her family for an epigastric mass accidentally discovered by her mother, with a history of decreased appetite, weight loss, and transit disorder during the last few months. At her examination, the girl was asthenic and pale. Abdominal palpation revealed a hardened, welldefined mass measuring about 24 x 12 cm, non-painful. The rest of the physical examination was regular.Given her father's work, the girl was transferred to the Military Hospital in Rabat, where an abdominal computed tomography found

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“…Due to the increasing incidence of neuropsychiatric disorders among children and adolescents during the SARS-CoV-2 pandemic and the relationship between psychiatric disorders and trichobezoars, an increase in the number of diagnoses of trichobezoars has been observed during the last few years [42]. Moreover, psychosocial stressors, familial dynamics, and potential genetic predispositions may play intricate roles and warrant further investigation [43].…”

Section: Bezoars and Psychiatric Disordersmentioning

confidence: 99%

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

Bellini,

Franzone,

Pezzotta

et al. 2024

Emergency Care and Medicine

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A 15-year-old girl was admitted to the Pediatric Emergency Department due to abdominal discomfort, anorexia, diarrhea, emesis, and weight loss. An inflammatory bowel disease diagnosis was suspected and a complete endoscopic investigation was deemed necessary. Initially, only colonoscopy with ileoscopy was performed, with evidence of widespread ileal ulcers, whereas a subsequent esophagogastroduodenoscopy revealed a huge trichobezoar that was further surgically removed. Trichobezoars are intraluminal conglomerates composed of ingested hair and are typically associated with underlying psychiatric disorders. Bezoars can be asymptomatic or present with various gastrointestinal symptoms, mimicking, among other conditions, inflammatory bowel disease. They may extend through the pylorus into the jejunum leading to Rapunzel Syndrome, which may cause intestinal obstruction. The treatment of trichobezoar depends on its location and volume. An endoscopic approach is possible for small-sized trichobezoars, but to avoid bezoar tail migration along the intestine, causing obstruction, conventional laparotomy is the only valid treatment for patients with Rapunzel Syndrome. Due to the increasing incidence of psychiatric disorders in pediatric age during the SARS-CoV-2 pandemic and their relationship with trichobezoars, an increase in cases of trichobezoars was observed. Thus, interdisciplinary collaboration between psychiatrists, pediatricians, and surgeons is crucial not only during the acute phase but also for long-term management and prevention of recurrence.

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Huge gastric trichobezoar caused by involuntary nocturnal trichophagia and trichotillomania in a female adolescent

Cited by 5 publications

References 15 publications

A rare cause of intestinal obstruction in children trichobezoar: How to diagnose?

A rare cause of intestinal obstruction in children trichobezoar: How to diagnose?

Huge gastric trichobezoar in school-aged girl: A Case Report

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

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