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. 2017 Apr-Jun;9(2):50-53.
doi: 10.4103/ijt.ijt_38_17.

Gastric Trichobezoars in Children: Surgical Overview

Alisha Gupta  1 , Deepak Mittal  1 , Maddur Srinivas  1
Affiliations

Gastric Trichobezoars in Children: Surgical Overview

Alisha Gupta et al. Int J Trichology. 2017 Apr-Jun.

Abstract

Background: Development of trichobezoars in children is primarily a psychiatric issue more than a pediatric surgical ailment. A definite history of trichotillomania and trichophagia may or may not be elicited. Surgical removal is required in patients presenting with huge bezoars. Psychiatric follow-up is of utmost importance to avoid recurrence.

Materials and methods: Records of children who were diagnosed and managed for the presence of gastric trichobezoars were retrospectively reviewed.

Results: Five children presented over past 15 years (2000-2015) with varied presentations ranging from asymptomatic abdominal masses to features of bowel obstruction. There were three adolescent females (aged 10, 12, and 13 years) and two males (aged 2 and 6 years). All had a hugely distended stomach completely filled with the bezoar. After gastrotomy and removal of the bezoar, gastrostomy drainage was provided in three of these five patients whereas the remaining two had nasogastric tube in place. All three with gastrostomy had effective gastric decompression and oral feeds could be established early. On the other hand, remaining two in which gastrostomy was not inserted had prolonged adynamicity of the stomach and delayed establishment of oral feeds.

Conclusion: A procrastinated history results in a hugely distended stomach which remains adynamic for a long period of time after removal of the bezoar, and decompression by gastrostomy tube drainage in the postoperative period is a feasible option.

Keywords: Child; gastrostomy; psychiatric illness; trichobezoar; trichotillomania.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Computed tomography scan of the abdomen showing the trichobezoar in the stomach and first part of the duodenum
Figure 2
Figure 2
Massively distended stomach brought out through the laparotomy wound
Figure 3
Figure 3
20 cm × 10 cm × 5 cm gastric trichobezoar with lower end extending across pylorus into the duodenum
See this image and copyright information in PMC

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