Gastric trichobezoar in a 4-year-old female patient with surgical resolution. Case report

Authors

DOI:

https://doi.org/10.56294/saludcyt2024716

Keywords:

Gastric Trichobezoar, Laparotomy, Abdominal Pain, Obstruction, Gastrostomy

Abstract

Introduction: bezoars are indigestible substances that accumulate in the gastrointestinal tract, most often in the stomach. Gastric Trichobezoar (GT) is the most common bezoar found in the stomach. According to their content, bezoars are divided into plant bezoars, capillary bezoars, lactose bezoars and medicinal bezoars. The most common complications reported over the years include gastric mucosal erosion, gastric or small bowel ulceration and perforation, gastric outlet obstruction, intussusception, obstructive jaundice, protein deficiency enteropathy, pancreatitis, and death. The treatment is surgery.
Clinical case: a 4-year-old female patient presents with cough and odynophagia, accompanied by abdominal pain located in the epigastrium, which persists and is exacerbated by movements, does not radiate, is accompanied by an unquantified rise in temperature, imaging studies are performed where it draws attention. Abdominal echo with report of mass at the level of the epigastrium, abdominal x-ray was performed with evidence of levels. They performed a simple abdominal tomography which confirmed the presence of a foreign body in the stomach classified as a bezoar.
Evolution: exploratory laparotomy + gastrostomy + trichobezoar extraction + gastric raphia was performed, a procedure without complications. Stable patient, without oxygen support, no signs of respiratory distress, tolerates feeding, better pain control, with good post-surgical evolution.
Conclusions: trichobezoars are extremely rare and pose diagnostic and treatment problems. Although laparoscopy currently seems to have promising results in expert hands, laparotomy remains the most successful surgical treatment. Postoperative psychological treatment is essential to correct patients' psychological and behavioral alterations and prevent their recurrence

References

1. Khalifa M Ben, Ghannouchi M, Nacef K, Chaouch A, Sellami M, Boudokhane M. Trichobezoar: A case report of a double gastric and ilial localization revealed by an occlusion. Int J Surg Case Rep. el 1 de febrero de 2022;91.

2. Harrabi F, Ammar H, Ben Latifa M, Gupta R, Ben Ali A. Gastric Trichobezoar Causing Gastrointestinal Bleeding: A Case Report. Cureus. el 14 de octubre de 2022;

3. Gástrico T, Pediátrico P, Sousa MC, Alves N, Herédia V. Gastric Trichobezoar in a Pediatric Patient [Internet]. Vol. 27, Acta Med Port. 2014. Disponible en: www.actamedicaportuguesa.com

4. Daoud R, Tlili A, Fendri S, Akrout A, Trigui A, Boujelbene S. Gastric trichobezoar: An uncommon cause of epigastric pain: A case report. Clin Case Rep. abril de 2022;10(4).

5. Bhattacharya J, Banerjee D, Maity C, Kumar Das M, Dutta S. Gastric Trichobezoar. Vol. 111, Journal of the Indian Medical Association. Indian Medical Association; 2013. p. 274.

6. Nm J, Rs S. Gastric Trichobezoar in a 6-Year Old Girl. Vol. 6, Gastric Trichobezoar APSP J Case Rep. 2015.

7. Diallo ID, Traore WYM, Zahraoui A, Moustapha EW, Moatassim Billah N, Nassar I. Trichobezoar: A Rare Cause of Gastric Obstruction. Glob Pediatr Health. el 1 de enero de 2023;10.

8. Morgado J, Gaspar J, Barros F, Rosado R. Recurrent gastric trichobezoar in a child. Einstein (Sao Paulo). el 1 de octubre de 2015;13(4):640–1.

9. Baek SG, Oh CH, Shin GY, Kim JW, Jang JY. Endoscopic retrieval of a huge gastric trichobezoar using an electrosurgical knife. Vol. 53, Endoscopy. Georg Thieme Verlag; 2021. p. 357–8.

10. de Melio J, Debrouwere T, Herman M. Trichobezoar. J Belg Soc Radiol. 2021;105(1).

11. Akbulut S, Deʇer KC, Duman M, Yol S. Gastric bezoars. Vol. 11, Przeglad Gastroenterologiczny. Termedia Publishing House Ltd.; 2016. p. 60–1.

12. Mazine K, Barsotti P, Elbouhaddouti H, Mouaqit O, Benjelloun E, Taleb KA, et al. Gastroduodenal trichobezoar: About a case. Pan African Medical Journal. 2018;30.

13. Paparoupa M, Schuppert F. Trichobezoar. Vol. 91, Mayo Clinic Proceedings. Elsevier Ltd; 2016. p. 275–6.

14. Ezziti M, Haddad F, Tahiri M, Hliwa W, Bellabah A, Badre W, et al. Trichobézoard gastrique: à propos d’un cas. Pan African Medical Journal. el 20 de febrero de 2017;26.

15. Coufal NG, Kansagra AP, Doucet J, Lee J, Coimbra R, Bansal V. Gastric trichobezoar causing intermittent small bowel obstruction: Report of a case and review of the literature. Vol. 2011, Case Reports in Medicine. Hindawi Limited; 2011.

16. Lacroix M, Colignon N, Azouz E, Radzik A, Arrivé L. Gastric trichobezoar with duodenal and jejunal extension. Clin Res Hepatol Gastroenterol. el 1 de enero de 2021;45(1).

17. Sabbah M, Ouakaa A, Bibani N, Trad D, Gargouri D. Gastric trichobezoar revealed by epigastric mass. Presse Medicale. el 1 de mayo de 2019;48(5):588–9.

18. Placone N, Mann S. A Trichobezoar of Gastric Proportions. Clinical Gastroenterology and Hepatology. el 1 de febrero de 2020;18(2):e18.

Downloads

Published

2024-01-01

How to Cite

1.
Aldaz Vallejo FA, Pérez Landázuri T del R, Manzano Quisimalin DE, Martínez JC, Bonilla Ortiz EE, Guerrero Ramos JM. Gastric trichobezoar in a 4-year-old female patient with surgical resolution. Case report. Salud, Ciencia y Tecnología [Internet]. 2024 Jan. 1 [cited 2024 Dec. 4];4:716. Available from: https://sct.ageditor.ar/index.php/sct/article/view/881