Hair loss in an infant presenting with failure to thrive

An 11-month-old male child with a complex past medical history presented for admission due to failure to thrive. He had hair loss throughout his scalp, and his abdomen was distended. There was parental report of hair pulling and hair in his stool. An upper gastrointestinal (GI) radiograph with fluoroscopy was performed and showed a filling defect in the gastric lumen. On endoscopy, he was found to have a gastric bezoar consisting of hair, nail, and food material. The trichobezoar was removed, and he began to tolerate feeds and showed consistent weight gain. There were no recurrence of symptoms 8 months following removal. While inadequate caloric intake is a common reason for failure to thrive, mechanical obstruction from a trichobezoar as a cause is rare and to our knowledge has not been reported in a child this young.