Amjad Waseem, Upadhya Gautham, Hurairah Abu, Iqbal Shahzad
Internal Medicine, Northwell-Long Island Jewish Forest Hills Hospital, Allama Iqbal Medical College, Forest Hills, New York, USA.
Internal Medicine, Brookdale University Hospital and Medical Center, Brooklyn, , New York, USA.
BMJ Case Rep. 2017 Oct 9;2017:bcr-2017-220923. doi: 10.1136/bcr-2017-220923.
Trichotillomania can be associated with the formation of trichobezoars (hair ball) usually located in the stomach. Trichobezoars may lead to complications including bowel obstruction, and perforation. Patients with a history of diabetes, certain psychiatric disorders, prior gastric surgery and poor mastication ability are at an increased risk of developing bezoars. We are presenting a case of patient who suffered from a large, recurrent trichobezoar, who had a history of gastric bypass surgery as well as trichotillophagia. The endoscopic method used to remove the large bezoar will also be discussed. We have reviewed the cases published, in which patients developed bezoars after undergoing gastric bypass surgery. The purpose of this study is to raise awareness among clinicians that patients with certain psychiatric issues who had prior gastric surgeries, are at eminent risk of bezoar formation. A multidisciplinary approach including cognitive behavioural therapy, dietary education and pharmacotherapy should be taken to prevent complications.
拔毛癖可能与毛粪石（毛球）的形成有关，毛粪石通常位于胃内。毛粪石可能导致包括肠梗阻和穿孔在内的并发症。有糖尿病史、某些精神疾病、既往胃部手术史以及咀嚼能力差的患者发生毛粪石的风险增加。我们报告一例患有巨大复发性毛粪石的患者，该患者有胃旁路手术史以及拔毛吞咽癖。还将讨论用于取出巨大毛粪石的内镜方法。我们回顾了已发表的病例，其中患者在接受胃旁路手术后发生了毛粪石。本研究的目的是提高临床医生的认识，即有某些精神问题且既往有胃部手术史的患者发生毛粪石的风险极高。应采取包括认知行为疗法、饮食教育和药物治疗在内的多学科方法来预防并发症。
