Gastrointestinal Trichobezoard Revealed by Intussusception at the University Hospital of Conakry

Camara Fode Lansana,Diallo Aissatou Taran,Diallo Amadou Dioulde,Balde Thierno Mamadou,Doumbouya Bourlaye,Toure Aboubacar,Camara Alpha Kabine,Toure Ibrahima,Camara Soriba Naby,Balde Abdoulaye Korse,Diallo Biro,Balde Oumar Taibata,Diakite Saikou Yaya,Balde Habiboulaye

doi:10.11648/j.js.20210901.15

Abstract

The aim of this is to make our contribution to the study of Gastrointestinal trichobezoard Introduction: The digestive bezoar is a conglomerate of indigestible substances trapped in the gastrointestinal tract. Aim: The aim was to report an exceptional case of a gastrointestinal trichobezoard revealed by acute intestinal obstruction by ileo-ileal intussusception and to discuss it with data from the literature. Methodology This was a 7-year-old girl who was referred to us from the Nutritional Institute at Donka National Hospital. She presented paroxysmal abdominal pain, vomiting, anorexia and physical asthenia without notion of gas stoppage, evolving for four months. On examination, the patient was in poor general condition with sunken eyeballs. The abdomen was the site of an epigastric mass, mobile and painful. The digital rectal examination noted an emptiness of the rectal bulb. The biological assessment revealed hyperleukocytosis (11.8giga/l); normochromium-normocytic anemia (10g/l). Abdominal ultrasound showed prominent images of distended loops, with material stasis, forming a mass syndrome consistent with a reducible and unstable invagination coil. The diagnosis of acute intussusception was ultrasound. Surgery confirmed intussusception, which was secondary to the entrapment of a trichobezoar in the gastrointestinal lumen. Intestinal disinvagination and extraction of trichobezoar by gastrotomy was the indication. Results the operative consequences were simple. Conclusion: Trichobezoar is a rare condition and the preoperative diagnosis difficult when the notion of trichophagia has not been mentioned. Its treatment is surgical, its prevention requires regular monitoring and psychiatric care.

Highlights

A bezoar is an indigestible conglomerate trapped in the gastrointestinal tract
There are four different types named after the material they are made of: trichobezoar resulting from ingestion of hair; phytobezoar made from vegetables and indigestible fruit fibers; the lacto-bezoar which is formed from curds and the pharmaco-bezoar caused by drugs [2, 3]
We report the exceptional case of a gastrointestinal trichobezoar revealed by acute intussusception

Summary

Introduction

A bezoar is an indigestible conglomerate trapped in the gastrointestinal tract This non-digestible mass can be formed by a variety of materials ingested intentionally or accidentally [1]. There are four different types named after the material they are made of: trichobezoar resulting from ingestion of hair; phytobezoar made from vegetables and indigestible fruit fibers; the lacto-bezoar which is formed from curds and the pharmaco-bezoar caused by drugs [2, 3]. Trichobezoars occur mostly in psychiatric disorders, such as trichotillomania and trichophagia They are more common in young women and are frequently located in the stomach with possible extension to the ileocolic junction; Phytobezoars are the most common type, usually affecting the narrowest part of the small intestine resulting in obstruction of the intestine by impaction. The majority of bezoars are found in the stomach, they sometimes travel from the stomach to the small intestine causing intestinal obstruction which is the most common complication of gastrointestinal bezoars [2, 4, 5]

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