Jejunal trichobezoar causing small bowel perforations in a child: A case report

Introduction: Trichobezoar is a rare gastrointestinal foreign body predominantly affecting young females. While typically confined to the stomach, migration can result in severe complications, including obstruction and perforation. Case presentation: A previously healthy 5-year-old female presented...

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Bibliographic Details
Main Authors: William C. Baumgartner, Casey L. Witmeyer, Shawn D. Safford
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Journal of Pediatric Surgery Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213576625000211
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Summary:Introduction: Trichobezoar is a rare gastrointestinal foreign body predominantly affecting young females. While typically confined to the stomach, migration can result in severe complications, including obstruction and perforation. Case presentation: A previously healthy 5-year-old female presented with acute abdominal pain, vomiting, and intolerance to oral intake. Initial imaging, including ultrasound and MRI, was inconclusive, but a subsequent CT scan revealed duodenal intussusception and significant gastric content. After endoscopy, the patient developed peritonitis, necessitating emergency surgery. Fourteen full-thickness perforations were identified along the mesenteric side of the jejunum, caused by a migrating trichobezoar. Ninety centimeters of small bowel was resected during the initial surgery, followed by two additional procedures for abdominal washout and resection of 15 cm of non-viable bowel. Pathology confirmed the diagnosis of trichobezoar. The patient recovered fully, tolerating oral feeds without recurrence of symptoms, and was discharged after 28 days of hospitalization. Conclusions: Trichobezoars of the small bowel are rare but should always be included in the differential diagnosis of children presenting with acute abdominal pain, even in the absence of a psychiatric history.
ISSN:2213-5766