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TRICHOBEZOAR WITH GASTRIC PERFORATION IN A 30 YEARS OLD FEMALE IN PAKISTAN: A CASE STUDY

Dr. Shahnawaz Abro1 , Dr. Ali Gohar Khan1 , Dr. Sadam Zia1

Trichobezoar is a Greek word trich, which means hair. Bezoars are collections of indigestible material that accumulate in the GI tract and are most often located in the stomach. Trichobezoars are often associated with psychiatric illness like trichotillomania and trichophagia usually occurs in young and adolescent females. In this case study, we present the 30 years old female who suffer from Trichobezoar with Gastric Perforation which is rare in nature. A 30-year-old woman resident of Dadu , presented in the emergency department of Liaquat University hospital Hyderabad/jamshoro in October 2018 , with the complain of pain in upper abdomen, constipation for last 10 days , vomiting for last 3 days and distention of abdomen. On examination patient look irritable abdomen was tense and tender on palpation, bowel sounds was absent. Ultrasound shows collection of free fluid in the peritoneal cavity and gas filled bowel loops no visceromegaly, and x-rays abdomen erect and supine shows gas under right dome of diaphragm. There was a past history of C-section and the socioeconomic status was average. On emergency exploratory laparotomy was performed and around two liters of pyoperitoneum was removed. And there was a 2×2 cm perforation was identified in the anterior wall of the prepyloric region of stomach. It is concluded that Gastric perforation is a rare complication of gastric trichobezoar formation. Without a history of trichotillomania or trichophagia, or findings on physical examination consistent with hair pulling behavior, one would not readily include this entity on their differential diagnosis of an acute abdomen. Key words: Trichophagia, Trichobezoar, Gastric, perforation

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