Akhtar N, Hashmi M A, Chaudary A, Tareen F, Jan I A.
Trichobezoar in Children: A Report of three cases.
Pak J Surg Jan ;18(1):31-4.

Bezoars are boluses of organic matter found in the stomach or the small intestine. With passage of time, they get mixed up with ingested food and solidify causing various grades of upper gastro-intestinal features including intestinal obstruction in children and problems of diagnosis. Trichobezoars are considered to be associated with underlying psychiatric or psychological problems responsible for eating such odd things, and therefore make psychotherapy an essential part of their overall management protocol. Bezoars are basically of four types depending on their constituent substance or materials. Those of vegetative origin (phytobezoars) and of milk curd origin (lactobezoars) or those of miscellaneous origin are quite common in children because of their inherent gastro-intestinal anatomy and inquisitive nature, but those consisting of a hair ball (trichobezoars) are extremely rare as most of the children neither have fully grown hair nor exhibit any gross psychological problems. The purpose of writing this paper is to report three of such patients who all presented with vague symptoms and were found to have hair balls filling their stomach and proximal gastro-intestinal tract. This is just to highlight that a very strong and abnormal psychiatric history is not essential to diagnose trichobezoar which should be kept in mind in any odd presentation pertaining to upper gastro intestinal tract.

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