The following are the complications of trichobezoars except
Rapunzel syndrome is the term for a trichobezoar (gastric 'hairball') which has a tail-like extension into the small bowel through the pylorus causing gastric outlet obstruction. Human hair (especially long hair) is resistant to digestion as well as peristalsis. So it tends to stay in the stomach and over a period of time may form a large 'hairball'. A trichobezoar may extend up to the pylorus, duodenum, or even jejunum. A pa may break off into small bowel and cause small bowel obstruction. For a discussion of other gastrointestinal foreign bodies, please see: bezoars Clinical presentation The patient usually is an adolescent girl. The patient may have a history of a psychiatric illness and occasionally a prior history of surgery may be present. The symptoms of Rapunzel syndrome is caused either by gastric outlet obstruction or its complications and includes: anorexia, bloating, early satiety weight loss vomiting immediately following meals acute epigastric pain patchy hair loss is seen in scalp hair Complications obstructive jaundice mechanical small bowel obstruction small bowel perforation peritonitis acute pancreatitis multiple complications of trichophagia included trichobezoars, malnutrition, intestinal obstruction, and ulceration with bleeding. One of the bouts of intestinal obstruction was associated with the superior mesenteric aery blocking the duodenum. Radiographic features Abdominal radiograph distended stomach shadow with an intragastric mottled gas pattern, outlined by fundal gas, which may resemble a food-led stomach free gas shadow under diaphragm may be seen on erect radiograph if bowel perforation is present Fluoroscopy: barium studies may show an intraluminal filling defect with mottled gas pattern without attachment to bowel wall over time the interstices of trichobezoar are filled with barium. This barium may remain for a considerable period of time and can be seen in delayed radiographs when the barium has exited the stomach and duodenum Ultrasound may be seen as an echogenic mass with intense acoustic shadow seen within stomach and pylorus region complex intraperitoneal free uid if complicated by bowel perforation CT CT is the best imaging modality for showing the size and configuration of the trichobezoar and most accurately identifying its location may show an intragastric well-circumscribed inhomogenous mass consisting of 'mottled gas pattern' or 'compressed concentric rings' pattern due to the presence of entrapped air and food debris body of the mass in stomach while tail may extend to the duodenum or jejunum normal stomach wall can be traced completely separate from the lesion no contrast enhancement mucosal edema and wall thickening may be seen in duodenum and jejunum Ref - Bailey and love 27e p1142
Haematemesis
Perforation and peritonitis
Obstruction
Malignancy
G.I.T