Trichobezoar as the underlying cause of an epigastric mass in an adolescent patient
1 Paediatric Clinic of the Bytom, Department of Paediatrics of the School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
2 Department of Paediatric Surgery and Urology in Katowice, School of Medicine, Medical University of Silesia, Katowice, Poland
Correspondence: Jolanta Pietrzak, MD, PhD, Paediatric Clinic of the Bytom, Department of Paediatrics, Stefana Batorego 15, 41-902 Bytom, Poland, tel./fax: +48 32 786 14 98, e-mail: pedbyt@sum.edu.pl
Pediatr Med Rodz 2017, 13 (2), p. 253–259
DOI: 10.15557/PiMR.2017.0027
ABSTRACT

Trichobezoar (hairball) is a foreign body typically located in the stomach, which is a collection of hair pulled out and swallowed as a result of trichotillomania and trichophagia. Its presentation usually lacks specificity, the exact constellation of symptoms correlating to the hairball’s precise location and size. The most frequent signs include epigastric pain, flatulence, nausea, bloating, dysphagia, satiety, loss of weight and halitosis. We report a case of a female patient with abdominal pain and nausea initially misdiagnosed as intestinal infestation, and subsequently, for several years, as gastroesophageal reflux. Physical examination disclosed an epigastric mass. Imaging examinations demonstrated a bezoar, and the patient was successfully treated by means of surgical extraction. The differential diagnosis of gastrointestinal symptoms, especially in young females, should account for trichotillophagia, hence the need to enquire after compulsive disorders when taking patient history. Successful removal of a trichobezoar should be followed by psychotherapy to prevent recurrence of symptoms.

Keywords: bezoar, trichobezoar, abdominal mass, adolescent