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Gastric trichobezoar in an end-stage renal failure and mental health disorder presented with chronic epigastric pain: A case report

BACKGROUND: Gastric trichobezoar happens when there is an indigestible substance or food found in the gastrointestinal tract. It is a rare presentation which is usually associated with trichotillomania and trichopagia. The presentation may not be specific and is usually related to dyspepsia-like sym...

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Autores principales: Ali, Aishath Azna, Gurung, Rajan, Fuad, Zeena Mohamed, Moosa, Muaz, Ali, Isha, Abdulla, Ahmad, Muhamad, Assikin, Hayati, Firdaus, Pang, Nicholas Tze Ping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7486413/
https://www.ncbi.nlm.nih.gov/pubmed/32953103
http://dx.doi.org/10.1016/j.amsu.2020.08.021
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author Ali, Aishath Azna
Gurung, Rajan
Fuad, Zeena Mohamed
Moosa, Muaz
Ali, Isha
Abdulla, Ahmad
Muhamad, Assikin
Hayati, Firdaus
Pang, Nicholas Tze Ping
author_facet Ali, Aishath Azna
Gurung, Rajan
Fuad, Zeena Mohamed
Moosa, Muaz
Ali, Isha
Abdulla, Ahmad
Muhamad, Assikin
Hayati, Firdaus
Pang, Nicholas Tze Ping
author_sort Ali, Aishath Azna
collection PubMed
description BACKGROUND: Gastric trichobezoar happens when there is an indigestible substance or food found in the gastrointestinal tract. It is a rare presentation which is usually associated with trichotillomania and trichopagia. The presentation may not be specific and is usually related to dyspepsia-like symptoms. In the worst-case scenario, this may cause gastric outlet or intestinal obstruction which eventually requires surgery. CASE PRESENTATION: We present a 36-year-old lady with underlying end-stage renal failure (ESRF) and undiagnosed mental health issues who was treated for recurrent episodes of gastritis. Imaging modalities revealed intragastric foreign body ingestion which is consistent with gastric trichobezoar. She eventually underwent laparotomy and gastrotomy to remove the foreign body. Postoperatively, she was referred and followed-up by the psychiatric team. CONCLUSION: Gastric trichobezoar has strong associations with psychiatric disorders. With the co-existence of an ESRF, uraemia might contribute to the aetiology of the trichotillomania and trichophagia. Open surgery is the choice of definitive management especially if bezoars are larger. Should the recurrence be remitted, a biopsychosocial modality and regular haemodialysis is the most sustainable approach to ensure the behaviour does not persist.
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spelling pubmed-74864132020-09-17 Gastric trichobezoar in an end-stage renal failure and mental health disorder presented with chronic epigastric pain: A case report Ali, Aishath Azna Gurung, Rajan Fuad, Zeena Mohamed Moosa, Muaz Ali, Isha Abdulla, Ahmad Muhamad, Assikin Hayati, Firdaus Pang, Nicholas Tze Ping Ann Med Surg (Lond) Case Report BACKGROUND: Gastric trichobezoar happens when there is an indigestible substance or food found in the gastrointestinal tract. It is a rare presentation which is usually associated with trichotillomania and trichopagia. The presentation may not be specific and is usually related to dyspepsia-like symptoms. In the worst-case scenario, this may cause gastric outlet or intestinal obstruction which eventually requires surgery. CASE PRESENTATION: We present a 36-year-old lady with underlying end-stage renal failure (ESRF) and undiagnosed mental health issues who was treated for recurrent episodes of gastritis. Imaging modalities revealed intragastric foreign body ingestion which is consistent with gastric trichobezoar. She eventually underwent laparotomy and gastrotomy to remove the foreign body. Postoperatively, she was referred and followed-up by the psychiatric team. CONCLUSION: Gastric trichobezoar has strong associations with psychiatric disorders. With the co-existence of an ESRF, uraemia might contribute to the aetiology of the trichotillomania and trichophagia. Open surgery is the choice of definitive management especially if bezoars are larger. Should the recurrence be remitted, a biopsychosocial modality and regular haemodialysis is the most sustainable approach to ensure the behaviour does not persist. Elsevier 2020-09-01 /pmc/articles/PMC7486413/ /pubmed/32953103 http://dx.doi.org/10.1016/j.amsu.2020.08.021 Text en © 2020 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Ali, Aishath Azna
Gurung, Rajan
Fuad, Zeena Mohamed
Moosa, Muaz
Ali, Isha
Abdulla, Ahmad
Muhamad, Assikin
Hayati, Firdaus
Pang, Nicholas Tze Ping
Gastric trichobezoar in an end-stage renal failure and mental health disorder presented with chronic epigastric pain: A case report
title Gastric trichobezoar in an end-stage renal failure and mental health disorder presented with chronic epigastric pain: A case report
title_full Gastric trichobezoar in an end-stage renal failure and mental health disorder presented with chronic epigastric pain: A case report
title_fullStr Gastric trichobezoar in an end-stage renal failure and mental health disorder presented with chronic epigastric pain: A case report
title_full_unstemmed Gastric trichobezoar in an end-stage renal failure and mental health disorder presented with chronic epigastric pain: A case report
title_short Gastric trichobezoar in an end-stage renal failure and mental health disorder presented with chronic epigastric pain: A case report
title_sort gastric trichobezoar in an end-stage renal failure and mental health disorder presented with chronic epigastric pain: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7486413/
https://www.ncbi.nlm.nih.gov/pubmed/32953103
http://dx.doi.org/10.1016/j.amsu.2020.08.021
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