Gastric trichobezoar associated with transient pancreatitis

Area of Science:

• Gastroenterology
• Pediatric Surgery
• Surgical Pathology

Background:

• Trichobezoars, or hairballs, are rare gastric foreign bodies, often associated with psychiatric conditions.
• Intestinal obstruction and abdominal pain are common presentations, but pancreatitis is an unusual complication.

Observation:

• A young Pakistani female presented with acute abdominal pain.
• Elevated serum amylase and alkaline phosphatase levels indicated pancreatic and biliary involvement.
• Imaging revealed a large gastric trichobezoar with an unusual extension into the mid-ileum.

Findings:

• Surgical exploration confirmed a gastric trichobezoar with a significant tail.
• Histopathological examination verified the diagnosis of trichobezoar.
• Postoperative normalization of liver enzymes and amylase levels was observed.

Implications:

• This case highlights the potential for gastric trichobezoars to cause atypical complications like pancreatitis.
• The bezoar's tail extending to the ampulla of Vater is the suspected mechanism for pancreatic irritation.
• Early diagnosis and surgical intervention are crucial for managing trichobezoar complications in pediatric patients.