pica and Bezoars

Rapunzel syndrome is a rare form of gastric trichobezoar. A 4-year-old girl presented with generalised oedema and an epigastric mass. Her family was of a relatively low socio-economic background. There was microcytic hypochromic anaemia, hypoalbuminaemia and an elevated α1-antitrypsin clearance. Abdominal ultrasound and non-contrast computed tomography demonstrated a heterogeneous mass related to the stomach. Upper gastro-intestinal tract endoscopy failed to remove it. Surgical laparotomy was undertaken through a single anterior gastrotomy incision and a large mass was extracted which was a cast of the duodenum and stomach and had a tail of approximately 60 cm in length which extended to the jejunum. Low socio-economic status, child neglect and pica are risk factors for trichobezoars. Surgical laparotomy is the optimal treatment of large bezoars.

Topics: Bezoars; Child, Preschool; Edema; Endoscopy, Gastrointestinal; Female; Humans; Infant; Laparotomy; Male; Pica; Radiography, Abdominal; Risk Factors; Socioeconomic Factors; Stomach Diseases; Tomography, X-Ray Computed; Ultrasonography

We report a 14-year-old girl who presented with epigastric pain, vomiting, and an upper abdominal mass. A diagnosis of trichobezoar was made on ultrasound and she went on to have a laparotomy, where a large trichobezoar was extracted with a tail that extended into the small intestine.

Topics: Adolescent; Bezoars; Duodenum; Female; Follow-Up Studies; Humans; Laparotomy; Pica; Risk Assessment; Stomach; Syndrome; Tomography, X-Ray Computed; Treatment Outcome

Topics: Anemia, Hypochromic; Bezoars; Child, Preschool; Humans; Male; Nutrition Disorders; Pica; Stomach

Topics: Abdomen; Bezoars; Digestive System Abnormalities; Foreign Bodies; Humans; Pica

Topics: Bezoars; Child; Female; Gastroscopy; Humans; Pica; Stomach; Tomography, X-Ray Computed

Trichobezoar is a rare condition that occurs mostly in young women with psychiatric disorders such as trichotillomania and trichophagia. We report the case of a giant gastric trichobezoar in a 21-year-old woman who presented with chronic abdominal pain, vomiting and weight loss. Abdominal examination revealed a large epigastric mass. Endoscopic and imaging findings were highly suggestive of a gastric trichobezoar. Surgical extraction of the huge hair mass was successfully performed through an open gastrotomy. Postoperatively, history of a neglected chronic depression with suicidal ideation was diagnosed. Consequently, the patient was referred to the psychiatric department for mental healthcare, to prevent trichobezoar recurrences.

Topics: Bezoars; Depressive Disorder; Female; Gastroscopy; Humans; Laparotomy; Pica; Stomach; Tomography, X-Ray Computed; Trichotillomania; Young Adult

A 16-year-old girl with a background of childhood trichophagia presented with a 2-day history of epigastric pain and associated anorexia with vomiting. An epigastric mass was palpable on examination. A CT scan revealed an intragastric trichobezoar, extending into the duodenum consistent with Rapunzel syndrome with evidence of partial gastric outlet obstruction and a possible perforation. The patient underwent an urgent laparotomy and extraction of the trichobezoar. The bezoar was removed without complication and no intraoperative evidence of perforation was detected. After an uncomplicated postoperative recovery, she was discharged home with psychiatric follow-up.

Topics: Adolescent; Bezoars; Female; Gastric Outlet Obstruction; Hair; Humans; Laparotomy; Pica

Trichobezoars are rare, but most commonly found in young women with trichophagia and trichotillomania. Complications can include iron deficiency anaemia and gastric erosion or, rarely, perforation. A 19-year-old woman presented with epigastric pain, vomiting and lethargy. Initial investigations revealed a palpable abdominal fullness on examination and iron deficiency anaemia. Oesophagogastroduodenoscopy found a large trichobezoar associated with gastric erosions, polyps and an ulcer. Subsequently, the patient reported previous consumption of artificial hair extensions, which ceased 5 years previously. Attempts to remove the trichobezoar by endoscopy were ineffective and in line with current literature, laparotomy was successful. This case describes a rare cause of trichobezoar and emphasises the importance of appropriate initial investigations and definitive management.

Topics: Abdominal Pain; Bezoars; Endoscopy; Female; Hair; Humans; Laparotomy; Pica; Vomiting; Young Adult

Rapunzel syndrome is a rare case of bowel obstruction resulting from hair ingestion (Trichobezoar). The obstruction can occur in any level of intestinal tract, but usually the stomach is primary involved. This syndrome is usually reported in patients affected by Trichotillomania or Pica syndrome, an obsessive-compulsive disorder that are characterized by an irresistible need to eat body hairs or non-digestible substances 1. When bowel obstruction occurs, it may be treated conservatively, but sometimes surgery is required. We reported two cases of Rapunzel Syndrome in two pediatric patients with different clinical presentation. Both patients were initially treated conservatively but eventually they underwent surgery. KEY WORDS: Bowel obstruction, Rapunzel syndrome, Trichobezoar.. La Sindrome di Raperonzolo è una rara causa di occlusione intestinale correlata alla presenza di un tricobezoar che si localizza a livello gastrico, il quale si estende anche a livello intestinale. I tricobezoar sono corpi estranei che si formano nell’apparato digerente a seguito dell’ingestione di capelli. È una patologia che si riscontra in particolar modo in pazienti affetti da disturbi psichiatrici quali la tricotillomania, disturbo ossessivo compulsivo in cui i pazienti tendono ad ingerire i propri capelli, e il picacismo, disturbo dell’alimentazione in cui i soggetti tendono a ingerire sostanze inorganiche-indigeribili. Il quadro occlusivo dovuto alla presenza di tricobezoar può essere trattato in modo conservativo, ma in casi gravi è necessario l’intervento chirurgico per la rimozione del corpo estraneo. In questo Case Report si discuterà della Sindrome di Raperonzolo e in particolare si discuterà di due casi clinici correlati a tale sindrome. I casi clinici riguardano due giovani pazienti con Sindrome di Raperonzolo, giunte alla nostra osservazione presentando quadri clinici diversi: un quadro di anemia sideropenica da malassorbimento e un quadro franco di occlusione intestinale da tricobezoar. Per gli scarsi risultati del trattamento conservativo, entrambe le pazienti sono state sottoposte ad intervento chirurgico di gastrotomia ed enterotomia in regime d’urgenza per la rimozione dei tricobezoar causanti i diversi quadri clinici.

Topics: Adolescent; Bezoars; Female; Humans; Pica; Stomach; Syndrome; Trichotillomania

Topics: Bezoars; Diagnosis, Differential; Female; Humans; Pica; Stomach; Stomach Neoplasms; Trichotillomania; Young Adult

A young adult black female, known to be a prostitute and suspected of smuggling narcotics, was found dead in her apartment in a state of early decomposition. Oval-shaped gray-white masses of exogenous origin protruded from the anus. The autopsy showed dilatation of the folds of the large intestine, which were almost completely filled with these oval-shaped gray-white masses of foreign material. The uterus was enlarged with multiple large leiomyomas. Toxicological tests of blood and the foreign material revealed no toxicologically relevant substances. Kaolin was detected in a sample of the foreign material from the large intestine. The immediate cause of death was intestinal obstruction due to the formation of a kaolin bezoar with simultaneous compression of the large intestine by the enlarged myomatous uterus. Subsequent revelation of a habit the deceased had brought from her native country led to the conclusion that this exotic custom was responsible for her death.

Topics: Bezoars; Fatal Outcome; Female; Foreign Bodies; Humans; Intestinal Obstruction; Kaolin; Leiomyomatosis; Nigeria; Pica; Sex Workers; Uterine Neoplasms; Young Adult

Iron deficiency anemia (IDA) and abdominal pain are commonly seen in a pediatric emergency department (8 and 18% incidence respectively in our center). They are manifestations of a wide variety of diseases ranging from benign to immediately life-threatening. Trichobezoar is an under-diagnosed entity that has to be considered in children and adolescents, expecially female, suffering from trichotillomania (compulsion to pull hair) and trichophagy (compulsion to swallow hair). When undiagnosed, gastric bezoars may cause gastric ulceration, perforation, haemorrhage and obstruction.. To underline the importance of including this pathology in the differential diagnosis of IDA and abdominal pain, we present the case of a 14 year-old girl with a huge trichobezoar which completely filled the stomach and extended into the small bowel. Since trichobezoar has an extension to the small bowel, it is classified as Rapunzel syndrome. As the bezoar couldn't be removed by endoscopy, the girl underwent surgical intervention. The patient passed through a gradual re-feeding, with iron and vitamins supplementation, and through a psychiatric counselling.. The Rapunzel syndrome is a rare entity that may be complicated by life-threatening events. A prompt diagnosis and an appropriate therapy can reduce comorbidities. Gradual re-feeding with supplementation of micronutrients allows adequate catch-up weight with normalization of haematochemical nutritional parameters. Since many of these patients suffer from psychiatric pathology such as PICA with emotional problems and mental retardation, psychological/psychiatric counselling plays an important role in order to prevent bezoar recurrence.

Topics: Abdominal Pain; Adolescent; Anemia, Iron-Deficiency; Bezoars; Diagnosis, Differential; Duodenum; Emergency Service, Hospital; Female; Humans; Pica; Stomach; Syndrome; Tomography, X-Ray Computed; Trichotillomania; Ultrasonography

Topics: Bezoars; Child, Preschool; Diarrhea; Female; Gastroscopy; Humans; Intestinal Obstruction; Intestines; Pica; Stomach; Syndrome; Vomiting

Topics: Adolescent; Bezoars; Calculi; Colon; Humans; Laxatives; Male; Pica; Radiography, Abdominal

Topics: Bezoars; Child; Enema; Gastrointestinal Tract; Humans; Male; Outcome Assessment, Health Care; Pica

Topics: Abdominal Pain; Bezoars; Dilatation, Pathologic; Foreign Bodies; Humans; Intestinal Obstruction; Male; Middle Aged; Pica; Schizophrenia

Topics: Bezoars; Female; Gastric Outlet Obstruction; Humans; Middle Aged; Pica; Stomach; Tomography, X-Ray Computed

Topics: Adolescent; Bezoars; Female; Humans; Pica; Trichotillomania

Ménétrier's disease is a rare protein-losing hypertrophic gastroenteropathy. While it still remains a medical curiosity, infection with Cytomegalovirus and Helicobacter pylori, and hormonal, congenital, dietary and neurogenic factors have been postulated as causative factors. We describe a case of a 14-year boy who presented with epigastric discomfort, vomiting, inability to gain weight and pedal oedema. Investigations revealed hypoproteinaemia without proteinuria and elevated faecal α-1-antitrypsin levels suggestive of protein-losing enteropathy. Imaging and endoscopic features demonstrated cerebriform gastric folds indicative of Ménétrier's disease. Infective, hormonal and neurogenic causes were ruled out in our patient. Surprisingly, the patient had a history of pica and an associated large gastric bezoar, which was ultimately removed surgically. An association of Ménétrier's disease with a bezoar has been reported only once previously. We thus add to the existing literature and highlight the plausible role of a bezoar as a causative factor in the pathogenesis of Ménétrier's disease due to its irritant nature.

Topics: Adolescent; Bezoars; Gastritis, Hypertrophic; Humans; Male; Pica; Stomach; Tomography, X-Ray Computed

Bezoar is defined as the accumulation of organic or nonbiological substances inside the gastrointestinal system. Trichobezoars are the most frequently detected ones and are mostly present in patients with neuropsychiatric disorders. The continuance of the trichobezoar tail-shaped extension over the duodenum and jejunum is described in Rapunzel syndrome. Both conditions are rarely reported in children. The present case submitted here is related to a 5-year-old girl referred with an abdominal mass and anemia, diagnosed with Rapunzel syndrome and developing trichobezoar due to iron deficiency and pica.

Topics: Anemia, Iron-Deficiency; Bezoars; Child, Preschool; Female; Humans; Jejunum; Pica; Stomach; Syndrome; Treatment Outcome

Topics: Abdominal Pain; Adolescent; Bezoars; Constipation; Female; Gastric Outlet Obstruction; Hair; Humans; Pica; Stomach

An 11-year-old girl with normal development and good academic progress at school presented with an abdominal mass. She lived with her aunt as her mother suffered from severe bipolar disorder and was unable to raise her. There were also multiple bereavements in the family. She had a history of alopecia and admitted to have eaten her hair to relieve stress. Examination was normal apart from a solid mass in the left hypogastrium. CT abdomen revealed a huge intra-abdominal mass covering most of the lumen. Open laparotomy was performed to remove the mass which was confirmed to be a trichobezoar. She made a good postoperative recovery and was discharged after 7 days. She has been referred to psychology services. Bereavement alone without psychiatric, physical disability or autism can be associated with trichobezoar. More studies are needed to study the association of trichotillomania, trichophagia and trichobezoar.

Topics: Alopecia; Bereavement; Bezoars; Child; Eating; Female; Hair; Humans; Laparotomy; Pica; Stomach; Trichotillomania

Topics: Anemia, Iron-Deficiency; Bezoars; Female; Humans; Jejunum; Pica; Stomach

Topics: Anemia, Iron-Deficiency; Bezoars; Female; Humans; Jejunum; Pica; Stomach

Topics: Adult; Autistic Disorder; Bezoars; Colon, Sigmoid; Dilatation, Pathologic; Humans; Male; Pica; Rectum; Tomography, X-Ray Computed

The majority of ingested foreign bodies pass of their own accord without causing any adverse impact on the patient, while others present a greater management dilemma. We present a case of a 36-year-old man admitted to the hospital with a 10-day history of colicky abdominal pain following voluntary ingestion of multiple pairs of vinyl gloves. The plain-film abdominal X-ray confirmed small bowel obstruction and gastric bezoar. After failed conservative management he opted for endoscopic retrieval. Following exposure to stomach acid the gloves had lost their structural integrity becoming hard, sharp and brittle. As a result endoscopic removal was abandoned due to the risk of traumatic injury to the oesophagus. A midline laparotomy was performed and the gloves were retrieved via enterotomy. While many foreign bodies are suitable for endoscopic extraction this case demonstrates that the retrieval of vinyl gloves is unlikely to be successful due to significant chemical change.

Topics: Adult; Bezoars; Conversion to Open Surgery; Foreign Bodies; Gastroscopy; Humans; Ileal Diseases; Intestinal Obstruction; Intestinal Perforation; Male; Pica; Treatment Outcome

Vinyl gloves when ingested will harden and develop sharp edges producing gastric bezoars; bowel obstruction; and, ultimately, perforation. We report 4 children with complications secondary to vinyl glove ingestion who required surgical intervention.. A 3-year-old boy, a 13-year-old adolescent girl with Down syndrome, a 14-year-old adolescent girl, and a 15-year-old adolescent boy presented with bowel obstruction secondary to a bezoar caused by a vinyl glove. The adolescent girl with Down syndrome presented again at age 17 years with a large vinyl glove gastric bezoar. Three of the children had mental retardation, and 1 was a victim of child abuse. Three had laparoscopic-assisted removal of the vinyl glove bezoar, and 1 had laparotomy.. The 4 children recovered uneventfully. Two of the patients had unsuspected intestinal perforation. The caretakers denied awareness of the vinyl glove ingestion.. Vinyl glove ingestion can cause intestinal obstruction and perforation. Vinyl gloves should be removed from the immediate proximity of mentally retarded patients or patients with pica. Most of the time, the finding of vinyl gloves as etiology of the obstruction or perforation is incidental. If the event is known or witnessed, prompt surgical intervention is generally recommended.

Topics: Adolescent; Bezoars; Child, Preschool; Female; Gloves, Protective; Humans; Intellectual Disability; Intestinal Obstruction; Intestinal Perforation; Intestine, Small; Laparoscopy; Laparotomy; Male; Pica; Stomach

Children and adolescents with sickle cell disease demonstrate an increased incidence of pica. Pica involving polyurethane foam has been previously reported, but effective management of such cases remains unclear. We present the case of a 17-year-old African American adolescent girl with sickle β+ thalassemia who presented with a long history of foam rubber pica resulting in intestinal obstruction. Conservative management was unsuccessful, and the patient ultimately required operative intervention. We advocate for a low threshold for early operation in cases of foam rubber bezoar.

Topics: Abdominal Pain; Adolescent; beta-Thalassemia; Bezoars; Depression; Female; Heterozygote; Humans; Ileal Diseases; Ileum; Intestinal Perforation; Peritonitis; Pica; Polyurethanes; Radiography; Sickle Cell Trait; Zinc

Topics: Adolescent; Autistic Disorder; Bezoars; Female; Humans; Pica; Stomach; Vomiting

A bezoar is an accumulation of indigestible exogenous matter in the stomach and intestine. A myriad of ingested substances have been found impacted in the digestive tract. Bezoars are uncommon causes of intestinal obtruction during childhood. Lithobezoar, an accumulation of ingested stones within the alimentary tract, is an extremely rare clinical entity. We report one such case in a 9-year-old boy with a history of pica and long-term constipation resulting in intestinal obstruction secondary to a colonic lithobezoar. Only two such cases have been reported previously.

Topics: Bezoars; Child; Colonic Diseases; Enema; Fecal Impaction; Humans; Intestinal Obstruction; Male; Pica

Bezoars and foreign bodies are frequently encountered in children with psychiatric disorders. Eating disorder (called pica) occurs predominantly in some high-risk patients such as psychiatric and mentally disabled children. Small-bowel obstruction is an uncommon complication of ingested foreign body because the foreign body is able to cross the whole small intestine and be excreted in the feces.We present the case history of an autistic adolescent who was operated on because of bowel obstruction due to an unusual foreign body.

Topics: Adolescent; Autistic Disorder; Bezoars; Cardia; Cellulitis; Diagnosis, Differential; Duodenum; Emergencies; Enterostomy; Foreign Bodies; Gastroscopy; Humans; Ileal Diseases; Intestinal Obstruction; Laparoscopy; Laparotomy; Male; Pica; Plant Structures; Umbilicus

An 11 year old boy with autism presented with a 2-month history of agitated behaviour with associated weight loss. On examination he was wasted and distressed. He had severe hypoalbuminaemia. Gastrointestinal imaging revealed a gastric bezoar. At operation a large phytobezoar extending into the jejunum was identified and removed. Postoperatively he required intensive nutritional resuscitation and support, including treatment of multiple micronutrient deficiencies. Malnutrition is common in children with developmental disabilities, with a number of possible contributing factors. Gastric bezoar is a rare cause, which should be considered in mobile children who may engage in pica.

Topics: Autistic Disorder; Bezoars; Child; Humans; Male; Pica; Psychomotor Agitation; Victoria; Weight Loss

Topics: Bezoars; Child, Preschool; Female; Hemoglobin C Disease; Humans; Pica; Radiography; Stomach

Topics: Bezoars; Child; Female; Hair; Humans; Microscopy, Electron, Scanning; Pica; Prognosis; Stomach; Stress, Psychological; Syndrome; Trichotillomania

Topics: Adult; Bezoars; Female; Humans; Interior Design and Furnishings; Intestinal Obstruction; Pica; Rubber

We report on a case of childhood coeliac disease presenting with tricophagia and trichobezoar. The combination of obstructive symptoms, severe hypoalbuminaemia and a large abdominal mass detected on CT scan warranted diagnostic gastroscopy and laparotomy, resulting in removal of a large gastric trichobezoar. Surgical recovery was uneventful although serologic studies for coeliac disease were abnormal. Coeliac disease was confirmed by subsequent biopsy.. Concomitant trichobezoar and coeliac disease in a child is reported for the first time. It is postulated that the trichobezoar was a result of coeliac disease-induced pica.

Topics: Bezoars; Celiac Disease; Child; Digestive System Surgical Procedures; Female; Humans; Laparotomy; Pica

Bezoars can be composed of a multitude of materials and can present in a wide variety of ways. The authors describe a young boy who had secretory diarrhea caused by an ileal bezoar composed of surgical adhesive tape. This report expands the literature on causes and presentation of intestinal bezoars in children.

Topics: Acidosis; Anastomosis, Surgical; Bezoars; Child, Preschool; Colectomy; Colostomy; Dehydration; Diarrhea; Hirschsprung Disease; Humans; Hyponatremia; Ileostomy; Ileum; Male; Pica; Postoperative Complications

Whereas small gastric bezoars may be removed endoscopically, large bezoars traditionally are removed at laparotomy. We describe a 33-year-old mentally retarded woman with pica syndrome who had experienced episodes of upper abdominal pain and distension of 10 months duration. Gastroscopy showed a large bezoar in the stomach, and attempted endoscopic removal was unsuccessful. The patient underwent laparoscopic extraction of the bezoar, which proved to be an ingested glove. She made an uneventful recovery and was discharged home on postoperative day 1. She had no wound complications, and her symptoms had not recurred at a 3-month follow up assessment. The operative technique is described, and the merits of the laparoscopic approach are discussed.

Topics: Adult; Bezoars; Clothing; Female; Humans; Intellectual Disability; Laparoscopy; Pica; Stomach

Topics: Adult; Aluminum Silicates; Bezoars; Child; Clay; Feces; Feeding Behavior; Female; Hair; Humans; Male; Pica; Pregnancy; Taste

This is a report of a 54-year-old schizophrenic patient with a 15-year history of ingesting metal objects (pica). He presented with severe anemia (hemoglobin of 3 g/dl and hematocrit of 8.3%) and leukopenia (white blood count of 1,300/mm3). Work-up revealed copper deficiency (copper level of <0.05 microg/ml) and elevated zinc levels (280 microg/ml). The zinc toxicity was produced by the zinc content in the coins ingested by the patient over a period of many years. He was initially treated with -acetylcysteine and sodium bicarbonate followed by intravenous copper sulfate. He was also placed on Adolph's meat tenderizer and pancreatin thrice a day orally to loosen the massive amount of metallic objects including coins in his bowel and allow them to pass out in his feces. He was also continued on oral copper sulfate. His copper levels began to rise and reached a maximum of 0.72 microg/ml, and his zinc level fell to 153 microg/ml. However, as he refused surgery to remove the metal objects from his bowel and continued to ingest more coins, there was continued absorption of zinc, which later overcame the efforts to reduce the zinc level and increase copper levels in his blood. He finally succumbed to sepsis and multiorgan failure. Autopsy revealed a coin mass in the stomach weighing 1,870 grams in addition to a sigmoid volvulus caused by another coin bezoar in the colon.

Topics: Anemia, Sideroblastic; Bezoars; Copper; Fatal Outcome; Humans; Male; Metals; Middle Aged; Multiple Organ Failure; Pica; Sepsis; Tomography; Zinc

Topics: Bezoars; Child, Preschool; Female; Humans; Nephrosis, Lipoid; Pica; Prednisolone

Topics: Animals; Bezoars; China; Deficiency Diseases; Feeding and Eating Disorders; Goat Diseases; Goats; Nutrition Disorders; Pica; Prevalence; Seasons; Sheep; Sheep Diseases; Wool

A 14-year-old female presented with the complaints of loss of hair, scalp pruritus, and pain in the abdomen. On careful work-up, she was found to have trichotillomania as well as trichophagia. Investigations also revealed a trichobezoar which completely filled the stomach. Hemogram showed moderate hypochromic anemia. Her detailed psychiatric profile showed a few additional features like obsessive hand washing, knuckle cracking, nose picking and body rocking. Her trichobezoar was removed surgically, and she had an uneventful post-operative recovery. She is being maintained on fluoxetine and is doing well. The role of a multi-disciplinary approach to trichotillomania patients is highlighted.

Topics: Adolescent; Bezoars; Female; Hair; Humans; Pica; Stomach; Trichotillomania

In humans, acquired copper deficiency anemia is rare. This report describes a 58-yr-old man with metal pica, especially coins, who presented with symptomatic anemia. His workup led to the diagnosis of zinc-induced copper deficiency. We believe that, in this man, leaching of zinc from pennies explained the clinical and laboratory findings. This case demonstrates that health care workers should consider the possibility of zinc-induced copper deficiency when confronted with patients with unexplained anemia who have ingested coins or other zinc-containing metals.

Topics: Bezoars; Copper; Foreign Bodies; Humans; Male; Middle Aged; Numismatics; Pica; Schizophrenia, Paranoid; Stomach; Zinc

To report experience with the treatment of complications of vinyl glove ingestion in mentally retarded patients with pica.. A retrospective case series.. Two university-affiliated hospitals.. Five mentally retarded patients, 4 with a history of pica, who were admitted for the management of complications resulting from the ingestion of vinyl gloves.. Type of complication, treatment and operative outcome.. The patients ranged in age from 26 to 46 years. One patient died while awaiting surgical consultation of massive gastrointestinal bleeding from a large gastric ulcer caused by a vinyl glove bezoar (VGB). Four VGBs were removed surgically. Endoscopic removal was difficult or impossible because the gloves had become hardened and matted.. VGB should be considered in institutionalized mentally retarded people with a history of pica when they present with gastrointestinal symptoms. VGBs should be removed directly by laparotomy, gastrotomy or enterotomy. Endoscopic removal is not recommended.

Topics: Adult; Bezoars; Female; Foreign Bodies; Gloves, Surgical; Humans; Intellectual Disability; Male; Middle Aged; Pica; Polyvinyls; Radiography

Topics: Abdominal Pain; Bezoars; Child, Preschool; Humans; Ileum; Male; Pica; Polyurethanes; Radiography

Topics: Adolescent; Anemia, Iron-Deficiency; Bezoars; Female; Humans; Pica; Plastics; Stomach

Topics: Acute Disease; Adult; Anemia, Iron-Deficiency; Bezoars; Clothing; Female; Humans; Pancreatic Pseudocyst; Pancreatitis; Pica; Stomach

Trichobezoars are a rare cause of upper gastrointestinal symptoms and most commonly occur in young females with trichophagia. A case, occurring in a 19 year old woman, complicated by transient pancreatitis and jejunal perforation, is presented.

Topics: Abdominal Pain; Adult; Bezoars; Female; Hair; Humans; Intestinal Perforation; Jejunal Diseases; Pancreatitis; Pica; Stomach

Topics: Adult; Bezoars; Diagnosis, Differential; Female; Humans; Lacquer; Pica; Psychophysiologic Disorders; Stomach; Stomach Neoplasms

The case is described of a three-year-old Moroccan girl with iron deficiency anaemia and a bezoar resulting from trichotillomania and trichophagy leading to a slowly developed obstruction ileus. Causes, symptoms and treatment of the various forms of bezoar are discussed.

Topics: Bezoars; Child, Preschool; Female; Humans; Intussusception; Pica; Radiography; Stomach; Trichotillomania

Topics: Bezoars; Child; Feeding Behavior; Female; Humans; Pica; Stomach

A 35-yr-old man with hematemesis, epigastric pain, and no predisposing factors to delayed gastric emptying was found to have a gastric bezoar. Surgical removal was required. Pathological and biochemical examination revealed a mass composed of polystyrene. This represents an unusual composition and a newly recognized predisposing factor to bezoar formation, "polystyrenomania" from ingestion of styrofoam cups.

Topics: Adult; Bezoars; Humans; Male; Pica; Polystyrenes

Topics: Bezoars; Child, Preschool; Female; Hair; Humans; Male; Pica; Radiography; Stomach

Topics: Anemia, Hypochromic; Bezoars; Child, Preschool; Female; Humans; Intussusception; Iron Deficiencies; Pica; Stomach

Topics: Anemia, Hypochromic; Bezoars; Child, Preschool; Humans; Intestinal Obstruction; Male; Pica

Topics: Bezoars; Child, Preschool; Digestive System Surgical Procedures; Female; Humans; Laparotomy; Pica; Recurrence

Topics: Adrenal Gland Neoplasms; Anemia, Hypochromic; Bezoars; Child, Preschool; Female; Ganglioneuroma; Hair; Humans; Infant; Pica; Trichotillomania

It has been known for several thousand years that concretions of animal and vegetable matter form in the stomachs and intestines of certain animals. These objects are known as bezoars. The finding of such curiosities in man is also recognised but is rare. A short history of bezoars is given and a case of a giant trichobezoar reported. The medical, surgical and psychiatric aspects are discussed.

Topics: Adolescent; Bezoars; Child; Female; Hair; Humans; Menstruation Disturbances; Mental Disorders; Pica; Radiography; Stomach; Ultrasonography

Topics: Bezoars; Child; Dietary Fiber; Female; Hair; Humans; Pediatric Nursing; Pica

Topics: Adult; Bezoars; Female; Humans; Ileum; Intestinal Obstruction; Paper; Pica; Radiography

Topics: Adult; Bezoars; Female; Gastrointestinal Diseases; Hair; Humans; Jejunum; Laparotomy; Pica; Stomach

Topics: Bezoars; Child; Duodenal Diseases; Female; Gastrectomy; Hair; Humans; Pica; Radiography; Stomach Ulcer

Topics: Adolescent; Bezoars; Duodenal Obstruction; Female; Hair; Humans; Pica; Pylorus; Radiography; Stomach

Topics: Bezoars; Digestive System; Feeding and Eating Disorders; Gastrointestinal Diseases; Humans; Intestinal Obstruction; Pica; Pregnancy; Pregnancy Complications

Topics: Appetite; Arteries; Bezoars; Digestive System; Duodenum; Foreign Bodies; Humans; Mesentery; Pica