Dumonceaux A, Michaud L, Bonnevalle M, Debeugny P, Gottrand F, Turck D
Unité de gastroentérologie, hépatologie et nutrition, hôpital Jeanne-de-Flandre, Lille, France.
Arch Pediatr. 1998 Sep;5(9):996-9.
Trichobezoars are composed of hair or fibres. The typical patient presenting with a trichobezoar is an adolescent girl experiencing mental disturbance or retardation.
Three girls with trichobezoars were seen. Two of them, 4 and 15 years old, had serious digestive antecedents (corrosive oesophagogastritis and oesophageal atresia, respectively) and had undergone previous surgery. The third was a 13-year-old mentally retarded girl. In two cases, an enzymatic dissolution trial was unsuccessful, requiring secondary surgical removal after, in one case, ineffective gastroscopic removal complicated by an oesophageal perforation. The third child had an initial operative removal.
Serious digestive antecedents may favour bezoars, a diagnosis that must be evoked in such patients presenting with chronic digestive symptoms. Enzymatic dissolution is ineffective for large bezoars, and gastroscopic removal carries some risks such as perforation or intestinal obstruction. Operative removal is usually indicated. Psychiatric follow-up is needed to prevent this complication in children with serious digestive antecedents and to reduce the risk of recurrences.
毛粪石由毛发或纤维组成。出现毛粪石的典型患者是患有精神障碍或智力迟钝的青春期女孩。
我们诊治了三名患有毛粪石的女孩。其中两名女孩，年龄分别为4岁和15岁，有严重的消化系统既往病史（分别为腐蚀性食管胃炎和食管闭锁），且之前接受过手术。第三名是一名13岁的智力迟钝女孩。在两例病例中，酶溶解试验未成功，其中一例在胃镜下切除无效并并发食管穿孔后，需要二次手术切除。第三个孩子最初接受了手术切除。
严重的消化系统既往病史可能易患粪石，对于出现慢性消化症状的此类患者必须考虑这一诊断。酶溶解对大的粪石无效，胃镜下切除有一些风险，如穿孔或肠梗阻。通常需要手术切除。对于有严重消化系统既往病史的儿童，需要进行精神科随访以预防这种并发症并降低复发风险。
