Trichobezoar

This is a 15 year old female patient complaining of chronic pain in epigastric region. Her mother gave a positive history of seeing hairs in her mouth during wake-up time. The behaviour and mental scoring was normal. CT shows a large mass of heterogenous material in stomach which is probably a combination of hairs and trapped food.
Bezoars are known to cause small bowel obstruction and sometimes CT may demonstrate the bezoar as a mass in the obstructed segment of bowel. The bezoar may be outlined by fluid in the proximally dilated small bowel, and the mass may be mottled owing to air trapped within it.
Types of bezoar -
(1) Trichobezoar is a bezoar formed from hair. This has also been called Rapunzel syndrome.
(2) Phytobezoars are composed of nondigestible food material (e.g. cellulose) and are frequently reported in patients with impaired digestion and decreased gastric motility.
(3) Pharmacobezoars (or medication bezoars) are mostly tablets or semi-liquid masses of drugs.
Reference: Delabrousse E, Brunelle S, Saguet O, et al: Small bowel obstruction secondary to phytobezoar CT findings. Clin Imaging 2001 Jan-Feb; 25(1): 44-6
Credit: Dr Abhijit Datir
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