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Trichobezoer: An Unusual Presentation with Congestive Heart Failure
Madeeha Malik1, Fatima Javed2, Bassam Helou3
1Vanderbilt University, Nashville, TN.
HCA Healthcare Journal of Medicine
|July 10, 2023
Summary
This case study highlights a rare gastric trichobezoar (GT) in a 40-year-old female, presenting with heart failure symptoms. Surgical removal of the hair impaction was successful after managing her cardiac condition.
Area of Science:
- Gastroenterology
- Psychiatry
Background:
- Trichobezoars are hair impactions in the GI tract, often linked to trichotillomania and trichophagia, predominantly in young females.
- Gastric trichobezoars (GT) are the most common type, with potential complications including gastric erosion, ulceration, and obstruction.
Observation:
- A 40-year-old female presented with dyspnea, edema, abdominal distension, weight loss, nausea, and vomiting, initially suspected as congestive heart failure.
- Physical examination revealed sinus tachycardia, displaced apex beat, and a split second heart sound.
- Upper endoscopy identified a large gastric trichobezoar.
Findings:
- The patient was markedly anemic and hypothyroid.
- Surgical removal of the gastric trichobezoar was performed after stabilization of her heart failure.
- The patient reported a history of hair pulling and swallowing under stress.
Implications:
- This case underscores the importance of considering rare gastrointestinal conditions like trichobezoars in patients with atypical presentations.
- Early diagnosis and management, including psychiatric support, are crucial for favorable outcomes.
- Gastric trichobezoars can mimic other serious conditions, necessitating a thorough diagnostic approach.
Keywords:
bezoarscongestive heart failuregastric bezoargastric obstructiongastric trichobezoarhypothyroidismtrichotillomaniaMore Related Videos
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