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Treatment of Children Trichobezoar a Retrospective Study of 11 Cases
Zhao HanBin1, Yang Chunjiang2, Wang Yi1
1Department of General Surgery & Neonatal Surgery, Liangjiang Wing, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics., Chongqing Medical University Affiliated Children's Hospital, Chongqing, China.
Insights
Pediatric trichobezoars, or hairballs, present with abdominal pain and vomiting, especially in children from single-parent or left-behind families. Surgical removal is key, with routine small intestine exploration to prevent complications like perforation.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Clinical Psychology
Background:
- Trichobezoars are rare gastric foreign bodies, often associated with psychological factors like trichophagia.
- Diagnosis and management in children can be challenging due to non-specific symptoms.
Purpose of the Study:
- To summarize clinical features, treatment, and prognosis of pediatric trichobezoars.
- To guide clinical diagnosis and treatment strategies for this condition.
Main Methods:
- Retrospective analysis of 11 pediatric trichobezoar cases.
- Review of clinical manifestations, auxiliary examinations, treatment, and family dynamics.
Main Results:
- 11 cases were female, with some from single-parent or left-behind families.
- Symptoms included chronic/acute abdominal pain, vomiting, and palpable abdominal masses.
- Ultrasonography identified gastric masses, with some extending into the small intestine.
- Four cases had jejunal perforation requiring surgical intervention (resection/anastomosis or repair).
- All patients improved post-operatively.
Conclusions:
- High suspicion for trichobezoars in children with abdominal pain, vomiting, and trichophilia, especially from vulnerable family structures.
- Surgical intervention is indicated for large gastric trichobezoars.
- Routine exploration of the small intestine during surgery is crucial to detect and manage perforations.
- Psychological support for patients and families is essential to prevent recurrence.
Purpose:
The goal of this study to summarize the clinical features, treatment and prognosis of children trichobezoar, and to guide the clinical diagnosis and treatment.
Methods:
The clinical manifestations, auxiliary examination results, diagnosis and treatment process and family relationship of 11 cases of children with trichobezoar in our hospital were analyzed retrospectively.
Results:
11 cases were female, 4 cases were divorced single parent family, and 2 case was left behind child. Six patients were admitted to hospital with sudden exacerbation of chronic abdominal pain, and four of them had recurrent vomiting. Five patients were admitted to hospital with acute abdominal pain, and 3 of them had vomiting symptoms; The weight of 1 case was lower than -2 SD, 4 cases were between -2 SD ~ -1 SD. 6 cases had palpable left upper abdominal mass with mild tenderness, 1 case only had left upper abdominal tenderness, 4 cases had no positive abdominal signs; The results of color Doppler ultrasonography in 8 children indicated the strong echo mass in the stomach, and 3 of them showed that the hyperechoic group extended to duodenum through pylorus. 7 cases had a tail end extending into the small intestine after removing the gastrolith during the operation. Four cases were found with jejunal perforation, 2 cases were treated with intestinal resection and anastomosis, and 2 cases were treated with intestinal repair. All the children were improved and discharged after operation.
Conclusion:
For single parent families or left behind children with a history of chronic abdominal pain, vomiting and trichophilia, gastric hair stones should be highly suspected. For large hair stones in the stomach, they should be removed surgically. During the operation, the small intestine should be explored routinely to prevent the missed diagnosis of small intestinal perforation. Psychological guidance should be given to the children and their parents to prevent recurrence.
