CASE REPORT: A 16 YEAR FEMALE WITH INTELLECTUAL DISABLITY PRESENTING AS TRICHOBEZOAR
*Dr. Shiwani Chowalta and Dr. Ankaj Sharma
Trichobezoars were first described by Baudomant in 1779 consisting of a compact mass of hair, occupying the gastric cavity to a various extent. The term “bezoar” is thought to be derived from the Arabic word for antidote – “bazahr” or “badzehr”, because stones obtained from the stomach or intestines of animals were thought to have medicinal properties.[1,2] Bezoars can be classified in four types: phytobezoar (vegetable); trichobezoar (hair); lactobezoar (milk/curd) and miscellaneous (fungus, sand, paper, etc). They are usually found in the stomach, but they may also be found in the duodenum and other parts of the intestine. The most frequent type of bezoar in adults is phytobezoar, while trichobezoars are more often found in children and teenage girls. The pathogenesis of bezoars is not consensual. It is believed that the smooth surface of hair does not allow for its propagation through peristalsis, getting trapped in the mucosa. When the trichobezoar is seen extending from the stomach to various lengths of the intestine is called “Rapunzel Syndrome”, for its resemblance to a tail. The diagnosis of trichobezoars is based on imagiologic evidence. Ultrasonography is effective in detecting an epigastric mass, although CT-scan is more accurate in revealing a characteristic bezoar image and allowing the identification of the presence of additional gastrointestinal bezoars. The definite diagnosis is established by endoscopy.
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