Best management modality of trichobezoar: A case report

INTRODUCTION: Trichobezoar is a rare condition, usually diagnosed in children and young female especially with psychiatric illness. Diagnosis of trichbezoar is usually dependent on the disease history, examination, diagnostic modality including CT scan. Generally this condition can be treated by endoscopy, laparoscopy or laparotomy. Here, we have presented a rare case of trichobezoar which has failed to be treated endoscopically but was eventually treated successfully by laparotomy. CASE REPORT: A 17 years old girl was presented with the initial complaint of epigastric pain for about 9 months duration with symptoms including vomiting and weight loss. Clinical examination showed tenderness and hard mass over epigastric area and it was extending towards the right hypochondrial area. CT scan results also showed that the stomach was filled with large intra-luminal abnormal mass like contents with mottled air pattern extended to fill the pylorus and first part of the duodenum. These findings were the proofs for possible trichobezoar. Endoscopic surgery failed significantly and hence laparotomy was performed, as a result, trichbezoar was removed successfully. DISCUSSION: Trichobezoar can be treated by using endoscopy for removal of hair, laparoscopy or Laparotomy. Laparotomy had 100% successful rate while 5% for endoscopy and 75% for laparoscopy. CONCLUSION: Laparotomy is the best treatment method for trichobezoare. Psychiatric management should be done for any patient with trichotillomania to avoid trichobezoar.