[Occlusion of the gastric outlet caused by a trichobezoar]

Bezoars are concretions formed in the gastrointestinal tract. The trichobezoars are hairballs in the stomach or intestines composed of hair. They are usually found in young girls as in our case which we operated in April 1989 on Surgical Ward in Kartal State Hospital in Istanbul. The postgastrectomy state predisposes to bezoar formation. Persimmon peels or pits, orange or grapefruit pulp are the usual offenders. Bezoars are associated with vague upper gastrointestinal discomfort, nausea, and vomiting. The patients may complain of abdominal pain. Ulceration, bleeding, obstruction, and perforation are the most common complications. Treatment consist of mechanical fragmentation via the endoscope or operative extraction. Dissolution of the undigested bolus by ingestion of proteolytic enzymes such as papain may be tried. As prophylaxis the postgastrectomy patient must be warned of ingesting citrus fruits.