Trichobezoar: surgical and psychiatric management | [Journal of College of Physicians and Surgeons--Pakistan : JCPSP • 2002]

Author(s):

1. Azam Yusuf: Department of Surgery, Rawalpindi Medical College, Rawalpindi, Pakistan.

2. Wasim Iqbal Sheikh: Department of Surgery, Rawalpindi Medical College, Rawalpindi, Pakistan.

3. Farid Minhas: Department of Surgery, Rawalpindi Medical College, Rawalpindi, Pakistan.

4. Riaz Ahmed Khokhar: Department of General Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan.

Abstract:

Surgical removal of trichobezoar only is incomplete management of the problem in majority of cases. Treatment of the underlying psychiatric illness, if present, is important to prevent recurrence. This study aims to focus the attention of the readers on the surgical and psychiatric management of trichobezoars and attempts to explore the underlying social factors in our set up leading to the psychiatric illness. Design: A non-interventional retrospective study. Place and Duration of Study : The study was carried out by collecting data of 9 cases from 5 teaching hospitals of Rawalpindi and Islamabad over a period of 5 years. Results: All the 9 patients were young females, majority (78%) of whom were unmarried. Most common mode of presentation was epigastric pain, vomiting and abdominal mass (89%) and weight loss (78%). Barium meal and endoscopy were the most accurate diagnostic modalities. Seven patients underwent laparotomy for the removal of the trichobezoar (gastrotomy / colostomy) with minimal complications. Six patients underwent psychiatric assessment in the postoperative period and all had disturbed interpersonal relationships either with parents, inlaws or teacher. Unfortunately all the patients referred to psychiatry OPD were lost to follow-up mainly because of the non-acceptance of the psychiatric illness by the relatives. There was suspected recurrence in one of them. Conclusion: The management of the problem is both surgical and psychiatric. Surgery to take care of the abdominal mass and psychiatric treatment for alleviation of the social factors for the prevention of recurrence.

Page(s): 97-101

DOI: DOI not available

Published: Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 12, Issue: 2, Year: 2002

Keywords:

Endoscopy , laparotomy , Trichotillomania , Gastrostomy , Trichobezoars

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