The Stomach Full of Hair-Trichobezoar

Abstract

Trichobezoars are rare masses of hair resulting from hair plucking (trichotillomania) and hair eating (trichophagia). Few of the hair may also be carried by peristalsis into the duodenum. This condition is known as Rapunzel syndrome. Complications include gastric perforation, small bowel obstruction and pancreatitis. Here the authors present a case of 20-year old female patient who presented with complaints of abdominal pain, early satiety and non-bilious vomiting. On examination, there was a swelling of size 10×5 cm predominantly in the epigastric and umbilical regions. Contrast Enhanced Computed Tomography (CECT) of the abdomen revealed a grossly dilated stomach with a heterogeneous mass in the lumen obstructing the pylorus. Upper gastrointestinal endoscopy confirmed the diagnosis of trichobezoar. Trichobezoar was removed by laparotomy and the patient had an uneventful recovery. Treatment is mainly laparotomy and minimally invasive methods can be used for small lesions with limited success rate. Psychiatric consultation is a must in all cases.