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Child with small bowel obstruction and perforation secondary to ileal bezoar

Javier F Quintana1, Robert N Walker, Ann McGeehan

  • 1Geisinger Medical Center, Danville, PA 17822, USA.

Pediatric Emergency Care
|February 19, 2008
PubMed

Insights

Bezoars, rare causes of intestinal obstruction, pose high risks if diagnosed late. This case highlights a child with a trichobezoar causing ileal perforation, emphasizing early diagnosis importance.

Area of Science:

  • Gastroenterology
  • Radiology
  • Pediatric Surgery

Background:

  • Bezoars are masses of indigestible material, typically found in the stomach, but can migrate and cause intestinal obstruction.
  • Intestinal obstruction due to bezoars, though rare, carries significant morbidity and mortality, especially with delayed diagnosis.

Observation:

  • This report details a pediatric case involving a trichobezoar (hairball) that migrated from the stomach to the distal ileum.
  • Initial radiographic findings were classic for a bezoar, but its distal location complicated diagnosis and management.

Findings:

  • The trichobezoar led to a small bowel perforation, a severe complication requiring surgical intervention.
  • Computed tomography (CT) and plain film imaging were crucial for identifying the bezoar and its complications.

Implications:

  • Early recognition of bezoars through advanced imaging is vital to prevent life-threatening complications like perforation.
  • The presence of a bezoar, particularly a trichobezoar, may warrant evaluation for underlying psychiatric conditions.

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