Management of Trichobezoar

Abstract

Background: Trichobezoar is an uncommon clinical entity in which ingested hair mass accumulates within the digestive tract. It is generally observed in children and young females with psychological disorders. It can either be found as an isolated mass in the stomach or may extend into the intestine. Untreated cases may lead to grave complications. Material and Methods: We retrospectively analyzed the clinical data of six patients treated for trichobezoar in Monastir pediatric surgery department during 16-year-period between 2004 and 2019. Imaging (abdominal computed tomography and upper gastroduodenal opacification) and gastroduodenal endoscopy were tools of diagnosis. Results: Our study involved 6 girls aged 4 to 12. Symptoms were epigastric pain associated with vomiting of recently ingested food in 3 cases and weight loss in one case. Physical examination found a hard epigastric mass in all cases. The trichobezoar was confined to the stomach in 4 cases. An extension into the jejunum was observed in 2 cases. Surgery was indicated in all patients. In two cases, the attempt of endoscopic extraction failed and patients were then operated on. All patients had gastrotomy to extract the whole bezoar even those with jejunal extension. Psychiatric follow-up was indicated in all cases. The six girls have evolved well and did not present any recurrence. Conclusion: open surgery still plays a crucial role in Trichobezoard management . After successful treatment, psychiatric consultation is imperative to prevent reccurrence and improve long term prognosis

Treatment of large gastric trichobezoar in children: Two case reports and literature review

“…Bezoars typically develop in the stomach and occasionally in the small intestine. [ 1 ] They are usually classified into phytobezoars (plant material), trichobezoars (hair), lactobezoars (milk), and pharmacobezoars (medications) according to their composition. [ 2 ] Trichobezoars are the accumulation and impaction of ingested hairs in the gastrointestinal tract.…”

“…[ 2 ] Trichobezoars are the accumulation and impaction of ingested hairs in the gastrointestinal tract. [ 1 , 2 ] They often result from continuous and prolonged habitual ingestion of human hair as well as fur from dolls, animals, and blankets. Trichobezoars are usually retained in the stomach.…”

“…[ 14 ] Although laparoscopic surgery is advantageous in view of cosmetic results and shorter length of hospital stay, an open approach is still performed in cases of large gastric trichobezoar due to the shorter operative time and less complication rate. [ 1 , 6 ]…”

“…Gastric trichobezoars are a rare form of bezoar formed from swallowed human hair as well as hair from dolls or animals, blankets, and carpets. [1][2][3][4] They usually develop in young women who are emotionally disturbed, depressed, or mentally retarded, with trichotillomania and trichophagia. [5][6][7][8][9] They can lead to abdominal pain, gastric ulceration, bleeding, obstruction, and perforation.…”

Bezoar in Meckel's diverticulum: Case report and narrative review

“…In our study, there were no reported psychiatric or gastrointestinal surgery histories as common risk factors for bezoar formation [ 4 , 5 , 9 ]. Dietary habits included excessive consumption of fruits or vegetables in 24.4 % of the cases and accidental ingestion of metallic objects in 17 % of the cases.…”