2022, Number 4
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Rev Fac Med UNAM 2022; 65 (4)
Gastric and Gastroduodenal Trichobezoar in Pediatrics. Report of 2 Cases and surgical Implications
Blanco TS, Jauregui PL, Carvajal TAE
Language: Spanish
References: 12
Page: 24-29
PDF size: 235.61 Kb.
ABSTRACT
The trichobezoar is a variety of bezoars whose characteristic
is the presence of a compact mass made up of indigestible
material, mainly hair and other components.
Presentation of cases: We present 2 cases of patients aged 4
and 9 years, who were admitted to an emergency room, with
symptoms of chronic evolution characterized by a palpable
abdominal mass, progressive weight loss associated with
trichophagia-trichotillomania, with presumed diagnosis of
gastric bezoar admission. The abdominal ultrasound in both
reported an echorefringent image inside that produces an
acoustic shadow, compatible with a probable trichobezoar,
a diagnosis reinforced by contrast-enhanced computed tomography.
Given the impossibility of endoscopic extraction
due to the large size, it was decided to perform exploratory
laparotomy, extracting the complete en-bloc mass through
a gastrotomy in both cases. The patients presented a favorable
evolution, receiving parenteral feeding for 5 days and
then oral ingestion with good tolerance, being discharged
from hospital on their 9th and 10th postoperative day with
interdisciplinary follow-up and psychological support. There
is a high suspicion of trichobezoar in the presence of trichotillomania,
affective compromise, psychomotor retardation,
intestinal symptoms and postsurgical neuropsychiatric management
is essential in order to reduce the risk of recurrence.
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