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10-17-2016, 10:32 PM
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| My Rank: PRIVATE Poster Rank:10571 Join Date: Aug 2015 Posts: 13 Mentioned: 0 Post(s) Quoted: 4 Post(s)
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Trichobezoar
A 17-year-old girl with a history of autism and trichotillomania presented to the emergency department with vomiting and abdominal pain of 48 hours' duration. The vital signs and results of a complete blood count and basic metabolic panel were unremarkable. Abdominal computed tomography with intravenous contrast revealed a heterogeneous, meshlike mass extending from the stomach into the duodenum, a finding consistent with a bezoar (Panels A and B, arrowheads). Endoscopic removal of the bezoar was attempted both before and after a 7-day trial of enzymatic dissolution with papain (administered orally as pineapple juice). This was unsuccessful, and 20 days after presentation, the patient underwent laparotomy. Transverse gastrotomy was performed (Panel C), and a large trichobezoar, forming a cast of the entire stomach, duodenum, and proximal jejunum, was removed en bloc (Panel D). The postoperative course was uneventful, and the patient was discharged on day 10 after surgery and referred to behavioral and mental health providers. (From the New England Journal of Medicine) Tricho = hair... this is a beazor (undigestible mass of eaten material) made of hair. |