Gastrointestinal trichobezoar: An experience with 17 cases
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In brief
In brief
Retrospective case series of 17 pediatric trichobezoar patients (median age 7 years) demonstrates that 54% presented with Rapunzel syndrome and 41% developed serious complications including bowel obstruction, perforation, and intussusception. Delayed diagnosis is common as trichobezoars mimic chronic conditions like tuberculosis or malignancy, emphasizing the need for high clinical suspicion in children with unexplained abdominal symptoms.
Written by the GCMD Library team from the article.
Abstract
Background
Trichobezoar is an exceedingly rare entity in children and mimics other chronic ailments such as abdominal tuberculosis or malignancy. Delayed diagnosis and management result in various complications. The study was conducted to describe our experience with 17 consecutive cases of gastrointestinal tract (GIT) trichobezoars.
Materials and methods
We reviewed medical records of 17 consecutive cases of GIT trichobezoar managed in our department between January 2005 and December 2018.
Results
There were 3 males and 14 females. The median age of presentation was 7 years. Fifteen patients (88%) presented with abdominal pain and vomiting, while 8 (47%) had abdominal distension. Seven (41%) patients developed complications secondary to the GIT trichobezoar (intussusception and gangrene in 1, small bowel obstruction in 4, gastric perforation and massive bleeding per rectum in 1, acute transient pancreatitis and hypertension in 1). At operation, 9 (54%) patients had Rapunzel syndrome, 6 (35%) had gastric trichobezoar, and 2 (12%) had small bowel trichobezoars.
One patient presented with massive bleeding per rectum and gastric perforation, succumbed postoperatively. One patient developed a recurrent trichobezoar.
Conclusion
GIT trichobezoar is rare in children and simulates chronic gastrointestinal ailments. Trichobezoars may reside in the alimentary tract, remain unnoticed for years, and become overt with the onset of complications.
The majority of trichobezoars had a tail in our series. Life threatening complications can occur with delayed presentations.
Type of study
Case series.
Level of evidence
Level IV.