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Published on: February 28, 2025

Gastric Trichobezoars in Children and Adolescents: A Single-Center Case Series

J Chami1, H Reusens2, V Weeda2

  • 1Department of Pediatric Gastroenterology, Queen Fabiola Children's University Hospital, Université Libre de Bruxelles (ULB).

Acta Gastro-Enterologica Belgica
|July 8, 2026
PubMed

Insights

Pediatric trichobezoars, hair masses in children, often present with vague symptoms and require surgical removal. Early diagnosis via CT scans and multidisciplinary care are crucial for favorable outcomes.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Child Psychiatry

Background:

  • Trichobezoars are ingested hair masses, primarily affecting children with trichotillomania and trichophagia.
  • Nonspecific symptoms can delay diagnosis, leading to severe complications like malnutrition or gastric perforation.

Purpose of the Study:

  • To describe the management experience of pediatric trichobezoars at a European tertiary pediatric center.
  • To highlight diagnostic challenges and treatment outcomes in pediatric trichobezoar cases.

Main Methods:

  • A retrospective single-center case series of pediatric gastric trichobezoar cases (2020-2025).
  • Data included demographics, clinical presentation, comorbidities, imaging, treatment, complications, and outcomes.
  • All patients underwent surgical extraction due to bezoar size preventing endoscopic removal.

Main Results:

  • Five pediatric patients (ages 6-15) diagnosed with gastric trichobezoars.
  • Common symptoms included vomiting, abdominal pain, and constipation; all had psychiatric comorbidities.
  • CT imaging was key for diagnosis, with gastrotomy required for extraction; two patients had postoperative complications.

Conclusions:

  • Pediatric trichobezoar necessitates invasive intervention for recurrent vomiting.
  • Delayed diagnosis due to nonspecific symptoms and psychiatric comorbidities is common; CT is vital for diagnosis.
  • Multidisciplinary management involving pediatrics, gastroenterology, and psychiatry is essential for preventing recurrence.
Abstract

Keywords:
Rapunzel syndromegastrotomypediatric surgeryrecurrent vomitingtrichobezoartrichotillomania

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