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

Abstract

Rationale: Gastric trichobezoars are a rare form of bezoar formed from swallowed human hair as well as hair from dolls or animals, blankets, and carpets. They usually develop in young women who are emotionally disturbed, depressed, or mentally retarded, with trichotillomania and trichophagia. They can lead to abdominal pain, gastric ulceration, bleeding, obstruction, and perforation.

Patient concerns: A 13-year-old girl was admitted to our institution with complaints of nausea, vomiting, and epigastric pain for 2 days. She underwent laparoscopic removal of a large gastric trichobezoar at our institution 5 years ago. A 12-year-old girl presented at our institution due to epigastric pain, dizziness, and melena for 2 days.

Diagnosis: They were diagnosed with gastric trichobezoar by abdominal computed tomography scan and upper gastrointestinal endoscopy.

Interventions: Large gastric trichobezoars were removed via a mini-laparotomy.

Outcomes: They recovered well postoperatively without complication.

Lessons: Although the recurrence of gastric trichobezoar after surgery is rare, few recurrent cases were reported in the literature. Therefore, psychiatric consultation and regular follow-up after treatment should be considered in the children and their parents to prevent the recurrence of gastric trichobezoar.

Figure 1.

Axial view of abdominal CT scan demonstrates a large intraluminal mass with entrapped air obstructing entire lumen of the stomach. CT = computed tomography.

Figure 2.

Recurrent gastric trichobezoar is confirmed by upper gastrointestinal endoscopy.

Figure 3.

Coronal view of abdominal CT scan demonstrates a large intraluminal mass occupying the entire stomach. CT = computed tomography.

Figure 4.

Wound retractor is used to expose the anterior wall of the stomach.

Figure 5.

A 22 × 7 cm-sized huge gastric trichobezoar after removal.