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

Al-Janabi, Issam S; A.Al-Sharbaty, Muthanna; Al-Sharbati, Marwan M.; Al-Sharifi, Laith A; Ouhtit, Allal

doi:10.1186/1752-1947-8-79

Cited by 19 publications

(25 citation statements)

References 26 publications

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“…Trichobezoar is a rare condition presenting in just 0.06–4% of the population [ 1 ] defined as a mass of swallowed hair in the stomach [ 1 , 2 ]. Due to the smooth and indigestible nature of hair, when swallowed it accumulates in the gastric mucosa and over time it mixes with food and mucus, becoming compacted and forming a solid mass known as a trichobezoar [ 1 , 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Bezoars are concretions of indigestible matter that accumulate in the gastrointestinal tract. Trichobezoars, specifically, are defined as masses of swallowed hair usually in the stomach [ 1 , 2 ] due to the smooth and indigestible nature of hair which when swallowed accumulate in the rugae of the stomach and over time, mixing with food and mucus, they become compacted and form solid masses. Most commonly, the bezoars produce obstructive symptoms but rarely may cause ulceration and even bleeding.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Rare Case of an Early Postoperative Obstructive Ileus in a Young Female Patient due to a Residual Trichobezoar Mass

Christopoulos

Ross-Thriepland

McCarthy

et al. 2016

Case Reports in Surgery

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Trichobezoar is a rare cause of small bowel obstruction, whereby a mass forms most commonly in the stomach and duodenum of young females, from ingestion of hair, a condition known as trichophagia. We present a case of recurrent small bowel obstruction due to a residual hair mass that was removed surgically in a young female patient who had a laparotomy and gastrotomy for removal of a large gastric trichobezoar just two weeks prior to the current admission. This case illustrates the importance of a thorough inspection of the whole bowel to ensure that no residual bezoars remain after surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Rare Case of an Early Postoperative Obstructive Ileus in a Young Female Patient due to a Residual Trichobezoar Mass

Christopoulos

Ross-Thriepland

McCarthy

et al. 2016

Case Reports in Surgery

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“…Surgeons should, therefore, examine the entire gastrointestinal tract to achieve complete elimination of trichobezoars and avoid secondary intestinal obstruction due to satellites. 5 In the present case, a laparoscopic approach was considered to be inappropriate, as CECT revealed gastric and multiple intestinal hair masses and remarkable small bowel dilatation. Moreover, intestinal wall weakness was suspected when we took into account the period from the onset of bowel obstruction to the surgery.…”

Section: Discussionmentioning

confidence: 99%

Obstruction of Small Bowel Caused by Unconscious Trichotillomania: Rapunzel Syndrome

Higashidate¹,

Iinuma²,

Hirayama³

et al. 2017

Emerg Med Open J

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Rapunzel syndrome is a relatively rare condition in which swallowed hair masses extend to a point distal to the pylorus and cause intestinal problems. Although trichotillomania and trichophagia are secondary to psychiatric illnesses, these conditions tend to be concealed by caregivers in most pediatric cases. Rapunzel syndrome sometimes manifests as acute abdominal symptoms of unknown origin and is difficult to manage appropriately. A 14-year-old female patient was referred to our hospital due to a small bowel obstruction. Although her medical history of trichotillomania was hidden at presentation, a definitive diagnosis of Rapunzel syndrome was made based on the findings from contrast-enhanced computed tomography (CECT). The patient underwent exploratory laparotomy, and hairballs were removed via an incision of the gastric and intestinal walls. The patient recovered uneventfully and was discharged on the 11 th post-operative day. Periodical psychiatric counseling is ongoing in order to prevent recurrence. Pediatric trichotillomania often progresses unconsciously, and appropriate care is necessary to prevent the development of a potentially fatal condition like Rapunzel syndrome. CECT is useful for making a definitive diagnosis of Rapunzel syndrome and determining the surgical approach. Radical laparotomy is considered to be reasonable and feasible in cases of Rapunzel syndrome, which manifests as acute abdominal symptoms.

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“…Previous studies have identified that the location and size of the bezoar have a direct impact on treatment modality, as well as overall success of the attempt [ 4 ]. The endoscopic approach is ideal for favorably sized trichobezoars (i.e., <6 cm) located within or proximal to the stomach [ 4 , 5 ]. Park et al compared clinical outcomes of patients with trichobezoars who underwent endoscopies and found that multiple endoscopic procedures were needed for bezoars greater than 6 cm [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Surgical removal remains necessary for large trichobezoars and Rapunzel syndrome with extension into the small bowel [ 4 , 6 ]. Case reports exist documenting unsuccessful attempts at endoscopic removal necessitating surgical extraction of the bezoar [ 5 ]. We report the case of a patient with a trichobezoar removed by endoscopy with extubation occurring as a result of the procedure.…”

Section: Introductionmentioning

confidence: 99%

Trichobezoar Causing Airway Compromise during Esophagogastroduodenoscopy

Kao

Scalzitti

Dion

et al. 2015

Case Reports in Medicine

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Objectives. (1) Report the case of a 5-year-old female with trichotillomania and trichophagia that suffered airway compromise during esophagogastroduodenoscopy for removal of a trichobezoar. (2) Provide management recommendations for an unusual foreign body causing extubation and partial airway obstruction. Methods. Case report of a rare situation of airway compromise caused by a trichobezoar. Results. A 5-year-old patient underwent endoscopic retrieval of a gastric trichobezoar (hairball) by the gastroenterology service under general endotracheal anesthesia in a sedation unit. During removal, the hairball, due to its large size, dislodged the endotracheal tube, effectively extubating the patient. The bezoar became lodged at the cricopharyngeus muscle. Attempts to remove the bezoar or reintubation were unsuccessful. The child was able to be mask ventilated while the otolaryngology service was called. Direct laryngoscopy revealed a hairball partially obstructing the view of the glottis from its position in the postcricoid area. The hairball, still entrapped in the snare from the esophagoscope, was grasped with Magill forceps and slowly extracted. The patient was then reintubated and the airway and esophagus were reevaluated. Conclusions. Trichobezoar is an uncommon cause of airway foreign body. Careful attention to airway management during these and similar foreign body extractions can prevent inadvertent extubations.

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

Cited by 19 publications

References 26 publications

A Rare Case of an Early Postoperative Obstructive Ileus in a Young Female Patient due to a Residual Trichobezoar Mass

A Rare Case of an Early Postoperative Obstructive Ileus in a Young Female Patient due to a Residual Trichobezoar Mass

Obstruction of Small Bowel Caused by Unconscious Trichotillomania: Rapunzel Syndrome

Trichobezoar Causing Airway Compromise during Esophagogastroduodenoscopy

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