Successful Gastrografin Enema Treatment of Obstruction of the Ileum Resulting From a Spilled Trichobezoar in an Eleven-Year-Old Girl : A Case Report

Abstract

Ileus due to spilled trichobezoar is extremely rare in Japan. But, in children almost all ileus due to bezoar are those due to trichobezoar. We show a child case of ileus due to trichobezoar which was resolved by gastrografin enema. An 11-year-old girl admitted for vomiting and lower abdominal pain was found in plain abdominal radiography to have multiple air-fluid levels. A long intestinal tube inserted on hospital day 4 did not improve symptoms. Gastrografin enema showed an oval shadow in the ileum. One day after gastrografin enema, intestinal obstruction was resolved and three masses of trichobezoar were defecated from the anus. Although surgical management had been the main therapy for ileus due to trichobezoar, gastrografin enema was useful for diagnosis of the cause of ileus and therapy to resolve the obstruction of the intestine.