Trichobezoar as an Uncommon Cause of Intestinal Obstruction and Surgical Emergency: Case Report
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Abstract
Introduction. Gastric bezoars are accumulations of indigestible material in the gastrointestinal tract that can lead to obstruction. Although rare, they are clinically significant and often associated with psychiatric and behavioral disorders, such as trichotillomania. This case report describes the clinical presentation, diagnosis, surgical management, and preventive considerations in a patient with a gastric trichobezoar and a background of psychiatric illness.
Clinical Case. A 30-year-old female with a history of moderate intellectual disability, organic schizophreniform disorder, and trichotillomania presented with progressive abdominal pain, vomiting, and marked abdominal distension. Physical examination revealed a palpable epigastric mass. Laboratory studies and abdominal computed tomography confirmed gastric chamber distension occupied by heterogeneous material. An exploratory laparotomy with gastrotomy was performed, successfully extracting a large trichobezoar.
Discussion. Gastric trichobezoars are primarily caused by chronic hair ingestion, predominantly in women with psychiatric comorbidities. Diagnosis typically requires imaging and endoscopy, but large bezoars necessitate surgical intervention. Early diagnosis and timely surgery are critical to prevent complications such as perforation and intestinal obstruction.
Conclusion. Multidisciplinary management, including psychiatric support and surgical treatment, is essential for optimal outcomes and to prevent recurrence. Education for the patient and family, coupled with continuous psychiatric follow-up, plays a vital role in comprehensive care.
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