Giant gastric and duodenal trichobezoar

Abstract

A 10-year-old girl was admitted with abdominal pain and vomiting that had started 2 weeks earlier, following weight loss during the previous 3 months. She had a 2-year history of ingesting hair and carpet fibers (trichophagia). On examination, a firm mass was palpable in the upper abdomen. Sonography revealed a voluminous and heterogeneous formation within the stomach. Upper gastrointestinal endoscopy showed a large bezoar occupying the entire stomach (Figure [1 ] a, b) and extending into the duodenum (Figure [1 ] c), making passage of the endoscope difficult. A few attempts were made to remove it endoscopically, using forceps and a snare, but these were unsuccessful. The trichobezoar was then surgically removed by gastrotomy. It measured 14 × 8 cm and had almost completely occluded the stomach and duodenum (Figure [2]). The girl had an uneventful postoperative course and was referred to a psychiatrist.