Management of Gastric Trichobezoar in Children: A Case Report and Literature Review

Background: Trichobezoar is a gastrointestinal obstruction formed from ingested hair, commonly associated with trichotillomania, a psychiatric disorder characterized by compulsive hair pulling and ingestion.   Case Presentations: This case report describes the clinical management of a ۱۲-year-old girl who presented with persistent nausea, vomiting, and abdominal pain. Her symptoms had intensified over the previous ۲۰ days. Her history revealed significant weight loss, dietary changes, and symptoms indicative of gastrointestinal distress. Physical examination identified a large non-mobile abdominal mass, and laboratory tests indicated elevated urea, lactate dehydrogenase, and alkaline phosphatase levels, suggesting underlying gastrointestinal pathology. Imaging studies confirmed the presence of a large heterogeneous mass in the stomach, leading to a diagnosis of trichobezoar. The surgical intervention involved laparotomy and removal of the trichobezoar, measuring approximately ۳۰ cm in length and weighing ۱۰۸۸ g. Pathological examination confirmed the mass as an intragastric trichobezoar. A psychiatric evaluation indicated that the patient had suffered from untreated trichotillomania for ۴ years. Conclusions: This case highlights the importance of recognizing the interplay between psychiatric disorders and gastrointestinal manifestations in pediatric patients. It underscores the necessity for a multidisciplinary approach that includes both surgical intervention and comprehensive psychiatric care to prevent recurrence. The management of trichobezoar must extend beyond physical treatment to address underlying psychological issues effectively. This report contributes to the existing literature on trichobezoar management in children and emphasizes the need for ongoing psychiatric support post-discharge to mitigate future complications.

کلیدواژه ها:

Trichobezoar ، Trichotillomania ، Gastrointestinal obstruction ، Case report