Trichotillomania, trichophagia, trichobezoar - summary of three cases. Endoscopic follow up scheme in trichotillomania

Aim. Trichotillomania is a lack of control of one's hair pulling. It is estimated that about 1% of population develops trichotillomania. In up to 20% of patients with trichotillomania hair pulling is followed by swallowing - trichophagia. Trichobezoar forms in about 30% of patients with trichophagia. Material and methods. In 2008-2014 three patients patient underwent surgery due to trichobezoar. One patient has had a history of trichotillomania. On admission abdominal Xray and ultrasonography revealed abdominal mass. Diagnosis was confirmed in abdominal computed tomography. Results. All trichobezoars were removed from the intestinal tract during laparotomy with gastric wall opening. In one case - Rapunzel syndrome - hair mass was also removed from the small bowel. After the surgical treatment all patients were referred to psychiatrist. Conclusions. In patients after a surgery due to trichobezoar as well as other patients with trichotillomania, control of hair accumulation in the gastrointestinal tract remains a problem. The authors propose endoscopic follow up scheme in 6, 12, and 24 months after the surgery as well as for other patients with trichotillomania.