Trichobezoars in the stomach and ileum and their laparoscopy-assisted removal: a bizarre case

Palanivelu C, Rangarajan M, Senthilkumar R, Madankumar MV
Correspondence: Dr Muthukumaran Rangarajan, rangy68@gmail.com

ABSTRACT
A trichobezoar is a ball of swallowed hair that collects in the stomach and fails to pass through the intestines. The risk is greater among the mentally retarded or emotionally disturbed children. We report a 12-year-old girl who presented with features of intestinal obstruction. Endoscopy revealed a trichobezoar in the stomach. Diagnostic laparoscopy also revealed a trichobezoar in the ileum. After gastrotomy and enterotomy, the two trichobezoars were removed through a minilaparotomy. Psychiatric problems associated with these disorders will need attention or recurrence can occur. Trichobezoars may need surgical removal if endoscopy fails. Endoscopical removal may not be possible if the lesion is large and hard. There are some reports of laparoscopy being used in removal surgery. It has the advantages of smaller incisions, better cosmesis and reduced pain.

Keywords: bezoar, endoscopy, laparoscopy, minimal access surgery, trichobezoar
Singapore Med J 2007; 48(2): e37–e39