Introduction: Bezoars are indigestible substances that accumulate in the gastrointestinal tract, most often in the stomach. Gastric Trichobezoar (GT) is the most common bezoar found in the stomach. According to their content, bezoars are divided into plant bezoars, capillary bezoars, lactose bezoars and medicinal bezoars. The most common complications reported over the years include gastric mucosal erosion, gastric or small bowel ulceration and perforation, gastric outlet obstruction, intussusception, obstructive jaundice, protein deficiency enteropathy, pancreatitis, and death. The treatment is surgery.
Clinical case: A 4-year-old female patient presents with cough and odynophagia, accompanied by abdominal pain located in the epigastrium, which persists and is exacerbated by movements, does not radiate, is accompanied by an unquantified rise in temperature, imaging studies are performed where it draws attention. Abdominal echo with report of mass at the level of the epigastrium, abdominal x-ray was performed with evidence of levels. They performed a simple abdominal tomography which confirmed the presence of a foreign body in the stomach classified as a bezoar.
Evolution: Exploratory laparotomy + gastrostomy + trichobezoar extraction + gastric raphia was performed, a procedure without complications. Stable patient, without oxygen support, no signs of respiratory distress, tolerates feeding, better pain control, with good post-surgical evolution.
Conclusions: Trichobezoars are extremely rare and pose diagnostic and treatment problems. Although laparoscopy currently seems to have promising results in expert hands, laparotomy remains the most successful surgical treatment. Postoperative psychological treatment is essential to correct patients' psychological and behavioral alterations and prevent their recurrence.
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