Trichobezoar Found Accidently while Diagnosing Resistance to Thyroid Hormone.

Area of Science:

• Gastroenterology
• Internal Medicine
• Surgical Pathology

Background:

• Bezoars are indigestible masses in the GI tract, with trichobezoars (hair) being common in children.
• A female patient presented with a 2-year history of mood deterioration, collapse, visual disturbances, and cardiac arrhythmia.
• Initial investigations suggested resistance to thyroid hormone (RTH) based on thyroid hormone levels.

Observation:

• Physical examination revealed a palpable upper abdominal mass.
• Abdominal ultrasound showed acoustic shadowing, indicating a pathological structure.
• Contrast X-ray of the digestive tract demonstrated a filling defect in the stomach.

Findings:

• Gastroscopy confirmed a large gastric trichobezoar.
• Surgical excision of the trichobezoar was performed successfully without complications.

Implications:

• This case underscores the importance of comprehensive diagnostics for non-specific symptoms, even when initial tests suggest other conditions.
• Accurate interpretation of diagnostic imaging in conjunction with clinical presentation is crucial for identifying rare pathologies like gastric trichobezoars.
• Investigating the underlying causes of trichobezoar formation is essential to prevent recurrence.