Trichobezoar is pathological ingestion of: September 2009
Ans. B: Hair Bezoars are collections or concretions of indigestible foreign material in the gastrointestinal tract. The term bezoars derives from the Arabic word Badzehr, which means antidote. Bezoars were used as antidotes and as magical medicinal agents against plague, snake-bite, sexual weakness, leprosy and epilepsy by physicians from 12th to 18th century. It can be trichobezoar or hairball, phytobezoar (food paicles/vegetable matter), trichphytobezoar (mixed), pharmacobezoar, lactobezoar, mycobezoar or pseudobezoar. Generally trichobezoars are in the stomach, but it may descend from the stomach into the intestine as far down as transverse colon termed as Rapunzel syndrome. The common presentation is as mobile and well defined lumps. They may present with malaise, weight loss, vague abdominal pain related to meals, anorexia, halitosis, vomiting, wasting and cachexia. They may cause a number of complications including gastritis, occult blood loss and secondary anemia, ulceration, perforation, obstruction, hemorrhage and intussusception. Diagnosis of trichobezoars rest on the clinical evidence of long standing trichophagy, abdominal mass and radiological investigations or CT scan and abdominal ultrasound but obtaining pieces of matted hair through endoscope is pathognomonic. Surgical removal at laparotomy or laparoscopeically is the treatment of choice. If small, they may be removed endoscopically. Biopsy devices, water jets, bezotomes and LASER devices may be used to fragment larger bezoars and lavaged out of the stomach. Counseling by a psychiatrist has an impoant role in the management to prevent recurrence. In any young girl, presenting with epigastric pain, vomiting and abdominal mass, trichbezoars should be considered as differential diagnosis
Vegetable matter
Hair
Coins
Stones