MULTIPLE TRİCHOBEZOARS

Bezoars are concretions in the gastrointestinal tract that increase in size by continuous accumulation of non-absorbable food or fibers. Most bezoars in children are trichobezoars from swallowed hair from the dolls or brushers. Trichobezoars typically cause abdominal pain and nausia, but can also present as an asymptomatic abdominal mass, progressing to intestinal obstruction and perforation. It is predominantly found in emotionally disturbed or mentally retarded youngers. We report a case of an unusual giant trichobezoar in 8-year-old girl. It was not extracted endoscopically, because it was huge and passed into the duodenum. Attempts at dissolving the bezoar with enzymes (papain) or meat tenderizers have not been efficacious. The abdomen was explored through a supraumblical median incision, an approximately 15X3 cm trichobezoar in diameter was identified in 50 cm distance from ileocecal segment, and was removed. In addition, ischemic and rupture 10 cm jejunal segment was repaired. These two rupture segments were repaired using Heineke Mikulicz procedure.