Smith Ria Emma, Rait Jaideep Singh, Said Amira, Dighe Shwetal
General Surgery, Darent Valley Hospital, Dartford, Kent, UK
General Surgery, Darent Valley Hospital, Dartford, Kent, UK.
BMJ Case Rep. 2020 Jan 26;13(1):e232720. doi: 10.1136/bcr-2019-232720.
Trichobezoars are rare, but most commonly found in young women with trichophagia and trichotillomania. Complications can include iron deficiency anaemia and gastric erosion or, rarely, perforation. A 19-year-old woman presented with epigastric pain, vomiting and lethargy. Initial investigations revealed a palpable abdominal fullness on examination and iron deficiency anaemia. Oesophagogastroduodenoscopy found a large trichobezoar associated with gastric erosions, polyps and an ulcer. Subsequently, the patient reported previous consumption of artificial hair extensions, which ceased 5 years previously. Attempts to remove the trichobezoar by endoscopy were ineffective and in line with current literature, laparotomy was successful. This case describes a rare cause of trichobezoar and emphasises the importance of appropriate initial investigations and definitive management.
毛粪石很罕见,但最常见于患有食毛癖和拔毛癖的年轻女性。并发症可能包括缺铁性贫血和胃糜烂,或极少情况下出现穿孔。一名19岁女性出现上腹部疼痛、呕吐和嗜睡症状。初步检查发现检查时可触及腹部饱满及缺铁性贫血。食管胃十二指肠镜检查发现一个大的毛粪石,伴有胃糜烂、息肉和溃疡。随后,患者报告曾在5年前使用过假发片,之后停用。通过内镜试图取出毛粪石未成功,与当前文献一致,剖腹手术成功。本病例描述了毛粪石的一种罕见病因,并强调了适当的初步检查和确定性治疗的重要性。