Pneumatosis intestinalis in a patient with trichobezoar – Rare association

Abstract

This case report describes a young girl who presented with chronic epigastric pain and abdominal mass without noticeable psychiatric illness or trichotillomania and subsequently trichobezoar was found to be the reason for her symptoms. She underwent laparotomy to retrieve the bezoar. During laparotomy extensive pneumatosis of the small bowel was noted where this association was not previously reported in the literature. Since pneumatosis was not symptomatic no bowel resection was carried out. She made an uneventful recovery. This illustrates that trichobezoar is an important cause to consider in young females with chronic abdominal pain even in the absence of clear evidence for trichotillomania. Rarely, this can be associated with intestinal pneumatosis. Intestinal pneumatosis does not warrant treatment unless it causes symptoms.

Keywords: Trichobezoar; epigastric pain; pneumatosis intestinalis; trichotillomania; pneumoperitoneum