are of

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43 Vol. 10. No.

1.

June 2004

Trichobezoar

- Two Cases of Unusual Presentation -

Doo Sun Lee, M.D.

Division of Pediatric Surgery, Department of Surgery, Dankook University College of Medicine Cheonan, Korea

Two cases of trichobezoar with unusual presentation in female children are described. The first case is a 7-year-old female with a 3-day history of abdominal pain, obstipation, and emesis. She developed intestinal obstruction and showed double bezoars in the stomach and intestine respectively. She had been in a habit of biting or sucking hairs before sleeping from infancy until 5 years of age. The other patient is a 6-year-old girl referred for an epigastric mass, emotional disturbance and trichotillomania. In spite of the psychological treatment, 4 laparotomies were necessary due to repeated recurrences.

(J Kor Assoc Pediatr Surg lO(l):43~46), 2004.

Index Words: Trichobezoar, Multiple, Recurrent, Rapunzel syndrome, Trichotillomania

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Correspondence : Doo Sun Lee, MD" Division of Pediatric Surgery, Department of Surgery, Dankook University College oj Medicine, Anseo-dong San 29, Cheonan 330-715, Korea

Tel: 041) 550-3928, Fax: 041) 550-3905 E-mail: [email protected]

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Fig. 1. Presentation of the case 1: Plain abdominal X-ray (A), depicted an ovoid mass outlined by air (arrows) in the right lower quadrant abdomen and multiple air-fluid levels; The trichobezoar (8), which has passed through the rectum after making intestinal obstruction; Upper gastrointestinal study (C), showing large filling defect with areas of trapped barium in the stomach; Surgically removed long-tailed trichobezoar (0), casting gastroduodenum.

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Fig. 2. Presentation of the case 2: The trichobezoar (A), which was removed surgically for the first time; Diffuse alopecia (8), as a result of trichotillomania.

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46

1. Stahlgren LH, Clearfield HR: Trauma, bezoars, and pther fhreign bodies in the stomach, in Berk JE, Haubrich WS, KaIser MH, Roth JAL, SchatTner F (cds):

Bockus Gastroenterology (ed 4), chap 81. Philadelphia, WB Satmders, 1985, Pp 1381- 1388

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3. Deslypere JP, Pract M, Verdonk G: An unusual case of trichobezoar: the Rapunzel ::'}'ndrome. Am J Gastroen- terol 77:467-470, 1982

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Giant trichophytobezoar in a pediatric patient 1v11h tri- chotillomania. Pediatr Radiol 33:219-220, 2003

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Km'ol T, Khalil H, Shah S: Small-ho1<licl ob- struction due to migratory trichohezoar in a child CT diagnosis. Am J Roentgeno1 177:255-256, 2001

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Fe,

Hepps KS, Dixon \VB: A method for the endoscopic retrieval of trichobezoars.

Gastrointest Endose 39:698-700, 1993

9. Kanetaka K, Azuma T, Ito S, Matsuo S, Yatnaguchi S, Shirono K, Kanematsu T: TH'o-channel method fbI' reo-i- eval of gastric trichohezoar: Report of a case. J Pediatr Surg 38:E7, 2003

are of

1.

Trichobezoar

- Two Cases of Unusual Presentation -

Doo Sun Lee, M.D.

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