Trichobezoar: A rare cause of chronic abdominal pain in childhood

Abstract

A 13-years-old girl presented in the Pediatric emergency in hypotensive shock state with complaints of abdominal pain and vomiting for last 15 days, that worsened over last 2 days. She had marked abdominal distension along with tenderness. The child was resuscitated immediately with intravascular volume replacement. X-ray abdomen revealed massive air under diaphragm and whole abdomen. CRP was markedly elevated i.e., 259g/L. After initial maximum possible stabilization with IV rehydration and antibiotics, patient underwent emergency laparotomy. One liter of purulent fluid was suctioned out. A hard mass of entangled hair was found in stomach with proximal stomach wall perforation. After mass removal and gut repair, patient remained in ICU for two weeks for completion of treatment with antibiotics and she had uneventful recovery later on. On follow up, the abdominal complaints were settled, and patient was in follow up with the psychiatry department for management of behavioral disorder for trichophagia.