2019 Volume 35 Issue 2 Pages 116-121
Trichobezoars are formed by ingested hair that coagulates in the stomach and sometimes causes intestinal obstructions. We report a pediatric case of gastrointestinal obstructions as a result of trichobezoars, which were successfully removed by laparotomy. An 11-year-old girl was referred to our hospital with acute abdominal pain and vomiting. An abdominal CT showed that the small intestine was dilated. At first, we suspected a non-strangulation of the ileum by an internal hernia. An emergency laparotomy was performed with a vertical midline incision. A trichobezoar was discovered in the ileum and removed. On postoperative day 6, an upper gastrointestinal contrast X-ray was performed and showed a second trichobezoar in her stomach. We attempted to remove the mass using an endoscopic procedure, but this proved difficult. A decision was made to undertake another laparotomy. The trichobezoar was found near the pylorus and removed. Her postoperative progress was satisfactory, with no recurrence. We need to consider that the gastrointestinal trichobezoar as a differential diagnosis of intestinal obstruction, if the patient has no history of surgery. In addition, we should try to better understand the imaging characteristics of trichobezoars and recognize the possibility of multiple trichobezoars before performing surgery.
