A Case of Duodenal Obstruction due to Trichobezoar

Tomokazu Kishiki, Kennji Miki, Masanori Teruya, Daisuke Endo, Yoshiharu Takenaka, Hozumi Tanaka, Takashi Kobayashi, Kaoru Kobayashi, Kouji Morita and Michio Kaminishi

Department of Surgery, Showa General Hospital

We report a case of duodenal obstruction due to gastric trichobezoar. An 11-year-old girl admitted for abdominal pain and vomiting, was found to have a firm mass palpated in the left upper abdomen. Blood studies showed elevated white blood cell counts, ALT, γ-GTP, and amylase. Computed tomography (CT) showed a large intraluminal gastric mass containing air and a mass with the same pattern in the duodenum. The girl had developed a habit of eating her hair as a 7-year-old, leading to a diagnosis of duodenal obstruction due to the trichobezoars. We removed the trichobezoars from the stomach and duodenum in emergency laparotomy. Gastric trichobezoar extended the trichobezoar to the duodenum, it was causing duodenal obstruction and elevated ALT, γ-GTP, and amylase. Diagnosis thus requires questions to patients about a history of trichophagia, in addition to suggestive CT findings.

Key words
trichobezoar, duodenal obstruction, computed tomography (CT)

Reprint requests
Tomokazu Kishiki Department of Surgery, Showa General Hospital
2-450 Tenjincho, Kodaira, 187-8510 JAPAN

Accepted
November 19, 2008

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