Case Reports in Gastroenterology
Published: January 2012
Tricholithobezoar Causing Gastric PerforationValenciano J.S.a · Nonose R.a · Cruz R.B.a · Sato D.T.b · Fernandes F.C.M.b · Nascimento E.F.a · Martinez C.A.R.caDepartment of General Surgery, São Francisco University Hospital, bSão Francisco University Medical School and cPost-graduate Program in Health Sciences of São Francisco University, Bragança Paulista (SP), Brazil
Carlos Augusto Real Martinez Rua Rui Barbosa, 255/32, Vila Boa Vista 09190-370 Santo André, SP (Brazil) Tel. +55 11 4438 9203, E-Mail caomartinez@uol.com.br |
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Abstract
A bezoar is an intraluminal mass formed by the accumulation of undigested material in the gastrointestinal tract. Trichobezoar is a rare condition seen almost exclusively in young women with trichotillomania and trichotillophagia. When not recognized, the trichobezoar continues to grow, which increases the risk of severe complications such as gastric ulceration and even perforation. Formation of a gallstone within the trichobezoar (tricholithobezoar) is an event that has not yet been described. We report the case of a 22-year-old woman admitted to the emergency room with signals and symptoms of an epigastric mass and perforative acute abdomen. Radiological study revealed bilateral pneumoperitoneum. Personal history revealed depressive syndrome, trichotillomania and trichophagia. With a diagnosis of visceral perforation, an urgent exploratory laparotomy was performed. This confirmed the diagnosis of gastric perforation due to a large trichobezoar with the formation of a gastrolith that was removed by anterior gastrotomy. Biochemical study of the gastric stone revealed that it was composed of bile salts. There were no complications. The patient was discharged on the 5th postoperative day and was referred for psychiatric treatment.
© 2012 S. Karger AG, Basel
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Article / Publication Details
Published online: January 13, 2012
Issue release date: January – April
Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 0
eISSN: 1662-0631 (Online)
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