J Chami, H Reusens, V Weeda, P Lingier, P Bontems, K Kotilea
{"title":"Gastric Trichobezoars in Children and Adolescents: A Single-Center Case Series.","authors":"J Chami, H Reusens, V Weeda, P Lingier, P Bontems, K Kotilea","doi":"10.51821/89.2.15484","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Trichobezoars are masses composed of ingested hair, typically affecting children and adolescents with trichotillomania and trichophagia. Their nonspecific presentation often delays diagnosis and may result in complications such as malnutrition or gastric perforation. This study describes our experience in managing pediatric trichobezoars at a tertiary pediatric center in Europe.</p><p><strong>Methods: </strong>Retrospective single-center case series of gastric trichobezoar cases in children treated at a tertiary pediatric hospital in Brussels, Belgium, between 2020 and 2025. Data extracted from electronic medical records included demographic, clinical presentation, comorbidities, imaging findings, therapeutic approach, complications, and outcomes.</p><p><strong>Results: </strong>Five pediatric patients (four females; age 6-15 years) were diagnosed with gastric trichobezoars. Recurrent vomiting, abdominal pain, early satiety, and constipation were the most common symptoms. Psychiatric or behavioral comorbidities were present in all cases, including trichotillomania, trichophagia, anxiety, or autism with pica. Ultrasound and plain radiography were unhelpful in all cases. CT raised suspicion of a bezoar in each patient, leading to endoscopic confirmation in three; however, the size of the trichobezoars prevented endoscopic removal. All patients underwent gastrotomy for bezoar extraction, performed via laparotomy in four cases and a laparoscopy-assisted approach in one. Postoperative complications occurred in two patients, including wound infection in two cases and postoperative pneumoperitoneum requiring re-exploration in one case. All patients received psychiatric follow-up, and clinical outcomes were favorable.</p><p><strong>Conclusions: </strong>Pediatric trichobezoar is a cause of recurrent vomiting that needs invasive intervention. Nonspecific symptoms and psychiatric comorbidities often delay recognition, and CT imaging is needed to establish the diagnosis, which can then be confirmed by endoscopy. Multidisciplinary management involving pediatrics, gastroenterology, and psychiatry is essential to prevent recurrence.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"89 2","pages":"413-418"},"PeriodicalIF":1.2000,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta gastro-enterologica Belgica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.51821/89.2.15484","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Trichobezoars are masses composed of ingested hair, typically affecting children and adolescents with trichotillomania and trichophagia. Their nonspecific presentation often delays diagnosis and may result in complications such as malnutrition or gastric perforation. This study describes our experience in managing pediatric trichobezoars at a tertiary pediatric center in Europe.
Methods: Retrospective single-center case series of gastric trichobezoar cases in children treated at a tertiary pediatric hospital in Brussels, Belgium, between 2020 and 2025. Data extracted from electronic medical records included demographic, clinical presentation, comorbidities, imaging findings, therapeutic approach, complications, and outcomes.
Results: Five pediatric patients (four females; age 6-15 years) were diagnosed with gastric trichobezoars. Recurrent vomiting, abdominal pain, early satiety, and constipation were the most common symptoms. Psychiatric or behavioral comorbidities were present in all cases, including trichotillomania, trichophagia, anxiety, or autism with pica. Ultrasound and plain radiography were unhelpful in all cases. CT raised suspicion of a bezoar in each patient, leading to endoscopic confirmation in three; however, the size of the trichobezoars prevented endoscopic removal. All patients underwent gastrotomy for bezoar extraction, performed via laparotomy in four cases and a laparoscopy-assisted approach in one. Postoperative complications occurred in two patients, including wound infection in two cases and postoperative pneumoperitoneum requiring re-exploration in one case. All patients received psychiatric follow-up, and clinical outcomes were favorable.
Conclusions: Pediatric trichobezoar is a cause of recurrent vomiting that needs invasive intervention. Nonspecific symptoms and psychiatric comorbidities often delay recognition, and CT imaging is needed to establish the diagnosis, which can then be confirmed by endoscopy. Multidisciplinary management involving pediatrics, gastroenterology, and psychiatry is essential to prevent recurrence.
期刊介绍：
The Journal Acta Gastro-Enterologica Belgica principally publishes peer-reviewed original manuscripts, reviews, letters to editors, book reviews and guidelines in the field of clinical Gastroenterology and Hepatology, including digestive oncology, digestive pathology, as well as nutrition. Pure animal or in vitro work will not be considered for publication in the Journal. Translational research papers (including sections of animal or in vitro work) are considered by the Journal if they have a clear relationship to or relevance for clinical hepato-gastroenterology (screening, disease mechanisms and/or new therapies). Case reports and clinical images will be accepted if they represent an important contribution to the description, the pathogenesis or the treatment of a specific gastroenterology or liver problem. The language of the Journal is English. Papers from any country will be considered for publication. Manuscripts submitted to the Journal should not have been published previously (in English or any other language), nor should they be under consideration for publication elsewhere. Unsolicited papers are peer-reviewed before it is decided whether they should be accepted, rejected, or returned for revision. Manuscripts that do not meet the presentation criteria (as indicated below) will be returned to the authors. Papers that go too far beyond the scope of the journal will be also returned to the authors by the editorial board generally within 2 weeks. The Journal reserves the right to edit the language of papers accepted for publication for clarity and correctness, and to make formal changes to ensure compliance with AGEB’s style. Authors have the opportunity to review such changes in the proofs.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
