Giant gastric trichobezoar

Introduction: Bezoars are clusters of ingested foreign bodies that form in the digestive tract; especially in the stomach. Case presentation: A young girl aged 13 consulted for an epigastric mass. The abdominal ultrasound showed a heterogeneous intragastric mass and a CT scan revealed a gray mass, impregnated by the orally ingested contrast product. Fibroscopy confirmed the diagnosis of trichobezoar. An attempt to remove the trichobezoar by endoscopy was unsuccessful and a laparotomy with gastrotomy enabled the extraction of a huge stomach-shaped trichobezoar. Discussion: Traditional factors usually involve gastric emptying disorders, problems following gastrectomy, a fibre-rich diet or gastric antisecretory drugs. Eating hair or other non-digestible materials or excessive consumption of indigestible foods may also lead to a bezoar. Fibroscopy remains the best technique for diagnosis and classification of bezoars. An abdominal CT scan will be used in cases of suspected intestinal obstruction or where injury may be involved, revealing the granite-like appearance of the bezoar in the stomach. Treatment is based on endoscopy, relayed by surgery in case of failure.