Giant gastric bezoar: A case report and the review of literature

Abstract

A bezoar is a packed collection of undigested or partially digested food found in the gastrointestinal (GI) tract. The stomach is the most common site of bezoars and bezoars are most commonly found in the stomach and can affect people of any age or gender. Patients with behavioral disorders, abnormal gastric emptying, altered GI motility as in diabetes disorders are predisposed to the formation of gastric bezoars. The majority of gastric bezoars are asymptomatic, whereas others require treatment in the form of endoscopic or surgical removal. Gastric bezoar can occasionally result in serious complications such as gastric outlet obstruction, bleeding, and perforation. As a result, early detection and treatment are critical to avoid potentially serious complications. We report an extremely rare case of giant gastric trichobezoar in a young female that was timely and successfully managed surgically. A 25-year-old female presented with symptoms of repetitive nausea and vomiting, especially postmeals, early satiety, intermittent abdominal pain, weight loss, and abdominal lump. An abdomen examination revealed a mass in the epigastric region extending to the right hypochondrium of 20 cm × 14 cm, firm to hard in consistency with a palpable inferior margin. Ultrasonography and contrast-enhanced tomography scan abdomen confirmed the diagnosis of gastric bezoar. The patient was prepared and Elective OT was done with the removal of a large gastric trichobezoar measuring 24 cm × 16 cm and weighing 1865 g. Gastrostomy closure was done in two layers and the postoperative period was uneventful. The patient is doing well and is on regular follow-up.