Scherrer M, Kornprat P, Sucher R, Muehlsteiner J, Wagner D. Mechanical upper bowel obstruction caused by a large trichobezoar in a young woman: A very unusual case report. World J Clin Cases 2024; 12(4): 777-781 [PMID: 38322694 DOI: 10.12998/wjcc.v12.i4.777]
Corresponding Author of This Article
Doris Wagner, FEBS, Assistant Professor, Department of Surgery, Division for General, Visceral and Transplantation Surgery, Medical University of Graz, Auenbruggerpl 29, Graz 8036, Austria. doris.wagner@medunigraz.at
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 6, 2024; 12(4): 777-781 Published online Feb 6, 2024. doi: 10.12998/wjcc.v12.i4.777
Mechanical upper bowel obstruction caused by a large trichobezoar in a young woman: A very unusual case report
Magdalena Scherrer, Peter Kornprat, Robert Sucher, Johanna Muehlsteiner, Doris Wagner
Magdalena Scherrer, Peter Kornprat, Robert Sucher, Doris Wagner, Department of Surgery, Division for General, Visceral and Transplantation Surgery, Medical University of Graz, Graz 8036, Austria
Johanna Muehlsteiner, Department of Surgery, Clinic Rohrbach, Rohrbach 4150, Austria
Author contributions: Wagner D and Muehlsteiner J were responsible for patient management, and drafting and revision of the manuscript; Scherrer M, Sucher R, and Kornprat P were responsible for conceptualization of the case report and drafting of the manuscript.
Informed consent statement: The patient provided written informed consent prior to the writing of the case report.
Conflict-of-interest statement: The listed authors - Magdalene Scherrer, Peter Kornprat, Robert Sucher, Johanna Mühlsteiner, and Doris Wagner - do not have any conflict of interests to disclose and did not receive any kind of funding and/or are currently not affiliated with any profit organization.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Doris Wagner, FEBS, Assistant Professor, Department of Surgery, Division for General, Visceral and Transplantation Surgery, Medical University of Graz, Auenbruggerpl 29, Graz 8036, Austria. doris.wagner@medunigraz.at
Received: August 22, 2023 Peer-review started: August 22, 2023 First decision: October 9, 2023 Revised: November 5, 2023 Accepted: January 8, 2024 Article in press: January 8, 2024 Published online: February 6, 2024
Abstract
BACKGROUND
Bezoars usually compile human fibers and debris. A special form of bezoar in case of psychologically altered individuals is the trichobezoar. It consists of voluntarily swallowed hair bulks and is normally removed via gastroscopy. Trichobezoars leading to ileus have rarely been reported.
CASE SUMMARY
A 24-year-old female patient presented to the emergency room with abdominal pain, nausea, and vomiting for 3 d. Her previous medical and psychiatric history was unremarkable. Laboratory analysis showed iron deficiency anemia, leukocytosis, and elevated liver enzymes. An abdominal CT scan revealed a dense structure in the patients’ stomach which turned out to be a huge trichobezoar completely obstructing the pylorus. The trichobezoar had to be removed surgically. During her postoperative course, a subcutaneous seroma formed. After a single puncture, the rest of the recovery process was unremarkable, and the patient recovered fully.
CONCLUSION
A mechanical bowel obstruction is a potentially life-threatening event for every patient. In our case a young female was suffering from severe symptoms of an obstruction which might have resulted in serious harm without successful surgical management.
Core Tip: A 24-year-old female patient presented to the emergency room with symptoms of a mechanical bowel obstruction. An abdominal CT scan confirmed the obstruction by a dense structure in the patients’ stomach which turned out to be a huge trichobezoar completely obstructing the pylorus. Endoscopic removal failed and therefore the trichobezoar had to be removed surgically. The patient recovered, underwent psychiatric treatment, and is well in her 24-mo follow-up since the operation.
