Epigastric mass in a young girl: trichobezoar. Imaging diagnosis.

A 16-year old girl presented with a history of abdominal pain, lump in epigastrium since one year. The ultrasound examination showed an epigastric mass, which was delineated as a filling defect in the stomach on barium studies. Upper GI endoscopy showed a large intragastric mass composed of hair. The CT scan showed a gastric mass extending to the duodenum. She was managed by surgical removal. A large gastric trichobezoar extending upto the jejunum was found. This case highlights the characteristic radiological appearance on barium, ultrasound and computed tomography of a bezoar within the stomach and a trichobezoar with a long tail extending upto the jejunum without intestinal obstruction is unusual.

Comparative study on a homemade rapid urease test with gastric biopsy for diagnosis of Helicobacter pylori infection.

The main objective of this study was to determine whether a homemade rapid urease test was reliable when compared to histology in the diagnosis of Helicobacter pylori infection. Endoscopic antral biopsies from 15th August 2004 to 15th July 2005 were studied prospectively. Rapid urease test and histological examination were done on all specimens. Among 160 biopsies, 56 cases showed H. pylori in histological section and 59 cases were rapid urease test positive. Among 56 H. pylori infected patients, the sensitivity, specificity, positive and negative predictive values, percentage of false positive, and percentage of false negative values of rapid urease test were 96.4%, 95.2%, 91.5%, 98.0%, 4.8% and 3.5% respectively. Rapid urease test is positive in significantly higher number (p < 0.001) in histological positive cases. In conclusion our homemade rapid urease test is a test with good sensitivity and specificity for detection of H. pylori infection.