Coexistence of bezoar and superior mesenteric artery syndrome: A case report

Bezoars are characterized by the presence of different undigested materials _mostly hair_ inside the digestive system due to a psychiatric disorder called Trichotillomania. Around 4 % of the population is affected by it [1]. Superior mesenteric artery is a medical condition that causes a compression on the duodenum between the superior mesenteric artery and the aorta with incidence rate of 2.67 % [2].

A 19-year-old female presented with a history of abdominal pain and a significant weight loss over the past year. The patient has a psychiatric history that began about 13 or 14 years ago, coinciding with the onset of the Syrian war leading her to engage in trichotillomania during episodes of fear and anxiety.

Bezoar symptoms usually appear when the size of the hair mass increases, leading to obstructions [7]. Its treatment depends on extracting the hair mass and giving psychiatric therapy to prevent recurrence [1]. Superior mesenteric artery syndrome is when the compression on the duodenum between the superior mesenteric artery and the aorta leads to the formation of an acute angle between the two vessels ranging from 6 to 25° [2,3]. The most important cause of this compression is weight loss [2,3]. Conservative treatment with good nutrition is preferred [2,3,8].

The psychological effects of wars should receive more care due to their significant effects on people's lives and health.