Trichobezoar Causing Small Bowel Obstruction: Case Report

We describe a case of a previously healthy 6-year-oldgirl presenting with a one-day history of bilious emesis, periumbilical pain, and feeding intolerance. Initial abdominal radiographs were unremarkable. Following continued episodes of bilious vomiting, an upper GI series was performed, which demonstrated coating of a non-occlusive intraluminal mass within the proximal jejunum. Serial abdominal radiographs document movement of the mass from the left upper quadrant to the right lower quadrant along with progressive dilatation of the proximal small bowel, suggesting small bowel obstruction. An abdominal CT confirmed a small bowel obstruction at the level of the barium coated intraluminal mass. At surgery, the obstruction was discovered to be due to a jejunal trichobezoar. Upon further retrieval of clinical history, it was determined that the patient had a history of eating her hair and couch cushions. A jejunal bezoar is a rare cause of small bowel obstruction. It can be a diagnostic challenge and can lead to significant complications if there is a delay in diagnosis. Throughout this case, we describe the clinical presentation of the patient and demonstrate the progression of radiographic findings of a small bowel trichobezoar.