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Asociación Mexicana de Gastroenterología

2005, Number 1

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Rev Gastroenterol Mex 2005; 70 (1)

Trichobezoar: presentation of three cases. Clinical and psychological profile

Bernal-Reyes R, Olvera ZF, Guerrero HRE

Language: Spanish
References: 44
Page: 67-72
PDF size: 77.22 Kb.


ABSTRACT

Introduction: The description of Trichobezoar is very ancient; it is an occasional entity and it mainly affects young women with deep psychopathology. Cases report: Three cases of teenagers with gastric Trichobezoar have been studied; their clinical evolution and diagnostic methods were analyzed. Their psychological profile and familiar environment were particularly studied in our hospital by gastroenterology and psychology. Discussion: Clinical manifestations are unspecified, however long-evolution dyspepsia is predominant and the diagnosis can be suspected for the young age of the patients, most of them females, with certain atypical personality characteristics with a palpable abdominal mass in the epigastrium in advanced stages of the illness; the most useful diagnosis methods are simple abdominal x-rays, UGI x-rays and endoscopy. Psychological evaluation revealed a familiar dysfunction in all of them. We observed a profile of dysfunctional personality in different degrees, including psychomotor retardation in two of them. All of the cases were solved surgically without complications. The last two cases, as well as their parents have received family psychotherapy, and now the evolution is favorable. Control endoscopies were made 6 months after the surgical event and do not show any trace of hair in the stomach.


REFERENCES

  1. Debakey M, Ochner A. Bezoars and concretions. A comprehensive review of the literature with an analysis of the 303 collected cases and a presentation of 8 additional cases. Surgery 1939; 5: 132-60.

  2. Sánchez MW, Rodríguez CDF, Luna-Pérez P. Síndrome de Rapunzel (tricobezoar). Rev Gastroenterol Mex 1997; 62(4): 284.

  3. Bustamante SJ, Rodríguez LL, Juárez RS y cols. Bezoar gástrico producido por pegamento sintético. Rev Gastroenterol Mex 1985; 50: 147.

  4. Phillips M, Zaheer S, Drugas G. Gastric trichobezoar: case report and literature review. Mayo Clin Proc 1998; 73: 653.

  5. Hani MA, Guesmi MF, Bouasker I y cols. Stomach perforation: an unusual complication of gastric bezoars. Tunis Med 2003; 81: 351.

  6. Assevero VE, Brooks DA, Cardozo WN y cols. Trichobezoars an expression of emotional disturbance. Am J Dis Child 1957; 94: 669: 71.

  7. Drewes AJ, Scheurer CD. Diagnostic image (163). A mentally retarded girl with progressive vomiting trichobezoar. Ned Tijdschr Geneeskd 2003; 147(44): 2173.

  8. Sariñan NC, Silva CA, Quintero HM y cols. Tricobezoar en el niño. Reporte de cuatro casos. Bol Med Hosp Infant 1957; 14: 523-32.

  9. Santos MM, Jiménez EB. Tricobezoar (presentación de un caso y revisión de la literatura). Rev Mex Ped 1971; 40: 773.

  10. Larbi N, Kaabi S, Ben Salah K. Gastric and intestinal bezoars. Tunis Med 2003; 81: 949.

  11. Baeza HC, Franco-Vázquez R. Tricobezoar gástrico y el síndrome de Rapunzel. Bol Med Hosp Inf Mex 1987; 44: 167.

  12. Vaughan D, Sawyers L y cols. An unusual complications of intestinal bezoar. Surgery 1966; 63: 339.

  13. McKay D. Teoría y terapéutica. En: Psicología clínica. México: Editorial CECSA 19; 1998.

  14. Hathaway SR, McKinley JC. Minnesota Multiphasic Personality lnventory (MMPI). Minneapolis: University of Minnesota Press; 1943.

  15. Anastasi A. Tests psicológicos. Madrid: Editorial Aguilar; 1998.

  16. Lynch KA, Feola PG, Guenther E. Gastric trichobezoar: as important cause of abdominal pain presenting to the pediatric emergency department. Pediatr Emerg Care 2003; 19(5): 343.

  17. Rajaonarison P, Ralamboson S, Ramanampamonjy R y cols. Trichobezoars, a little known clinical entity. Arch Inst Pasteur Madagascar 2001; 67: 65.

  18. Mishra DS, Magu S, Sharma N y cols. Imaging in acute abdomen. Indian J Pediatr 2003; 70: 15.

  19. El Hajjam M, Lakhloufi A, Bouzidi A, Kadiri R. CT features of a voluminous gastric trichobezoar. Eur J Pediatr Surg 2001; 11(2): 131.

  20. Bouwer C, Stein D. Trichobezoars in trichotillomania: case report and literature overview (Report). Psychosomatic Medicine 1998; 60(5): 658.

  21. Memon SA, Mandham P, Oureshi JN y cols. Recurrent Rapunzel Syndrome: a case report. Med Sci Monit 2003; 9: CS92.

  22. 22.Ratnagiri R, Smile SR, Sistia SC. Recurrent gastric trichobezoar. Indian J Gastroenterol 2002; 21: 229.

  23. Debakey M, Ochner A. Bezoars and concretions. A comprehensive review of the literature with an analysis of the 303 collected cases and a presentation of 8 additional cases. Surgery 1939; 5: 132-60.

  24. Sánchez MW, Rodríguez CDF, Luna-Pérez P. Síndrome de Rapunzel (tricobezoar). Rev Gastroenterol Mex 1997; 62(4): 284.

  25. Bustamante SJ, Rodríguez LL, Juárez RS y cols. Bezoar gástrico producido por pegamento sintético. Rev Gastroenterol Mex 1985; 50: 147.

  26. Phillips M, Zaheer S, Drugas G. Gastric trichobezoar: case report and literature review. Mayo Clin Proc 1998; 73: 653.

  27. Hani MA, Guesmi MF, Bouasker I y cols. Stomach perforation: an unusual complication of gastric bezoars. Tunis Med 2003; 81: 351.

  28. Assevero VE, Brooks DA, Cardozo WN y cols. Trichobezoars an expression of emotional disturbance. Am J Dis Child 1957; 94: 669: 71.

  29. Drewes AJ, Scheurer CD. Diagnostic image (163). A mentally retarded girl with progressive vomiting trichobezoar. Ned Tijdschr Geneeskd 2003; 147(44): 2173.

  30. Sariñan NC, Silva CA, Quintero HM y cols. Tricobezoar en el niño. Reporte de cuatro casos. Bol Med Hosp Infant 1957; 14: 523-32.

  31. Santos MM, Jiménez EB. Tricobezoar (presentación de un caso y revisión de la literatura). Rev Mex Ped 1971; 40: 773.

  32. Larbi N, Kaabi S, Ben Salah K. Gastric and intestinal bezoars. Tunis Med 2003; 81: 949.

  33. Baeza HC, Franco-Vázquez R. Tricobezoar gástrico y el síndrome de Rapunzel. Bol Med Hosp Inf Mex 1987; 44: 167.

  34. Vaughan D, Sawyers L y cols. An unusual complications of intestinal bezoar. Surgery 1966; 63: 339.

  35. McKay D. Teoría y terapéutica. En: Psicología clínica. México: Editorial CECSA 19; 1998.

  36. Hathaway SR, McKinley JC. Minnesota Multiphasic Personality lnventory (MMPI). Minneapolis: University of Minnesota Press; 1943.

  37. Anastasi A. Tests psicológicos. Madrid: Editorial Aguilar; 1998.

  38. Lynch KA, Feola PG, Guenther E. Gastric trichobezoar: as important cause of abdominal pain presenting to the pediatric emergency department. Pediatr Emerg Care 2003; 19(5): 343.

  39. Rajaonarison P, Ralamboson S, Ramanampamonjy R y cols. Trichobezoars, a little known clinical entity. Arch Inst Pasteur Madagascar 2001; 67: 65.

  40. Mishra DS, Magu S, Sharma N y cols. Imaging in acute abdomen. Indian J Pediatr 2003; 70: 15.

  41. El Hajjam M, Lakhloufi A, Bouzidi A, Kadiri R. CT features of a voluminous gastric trichobezoar. Eur J Pediatr Surg 2001; 11(2): 131.

  42. Bouwer C, Stein D. Trichobezoars in trichotillomania: case report and literature overview (Report). Psychosomatic Medicine 1998; 60(5): 658.

  43. Memon SA, Mandham P, Oureshi JN y cols. Recurrent Rapunzel Syndrome: a case report. Med Sci Monit 2003; 9: CS92.

  44. Ratnagiri R, Smile SR, Sistia SC. Recurrent gastric trichobezoar. Indian J Gastroenterol 2002; 21: 229.




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