ABSTRACT
Trichobezoard is a rare condition characterized by a gastric mass composed of hair or fibers due to a compulsive attitude (trichotillomania) and an eating disorder (trichophagia). Gastric trichobezoar is the most common form and may extend into the small bowel, sometimes reaching the last ileal loop, or even the transverse colon, resulting in Rapunzel syndrome. We here report a case of gastroduodenal and small intestine trichoboozoar in a 6-year-old girl with facies of trisomy, presenting with recurrent abdominal pain lasting for one months and suspected gastrointestinal lymphoma. The diagnosis of trichoboozoar was based on surgery. The purpose of this study is to give an overview of the history of this rare condition and to clarify the diagnostic and therapeutic approaches used.
Subject(s)
Bezoars , Down Syndrome , Trichotillomania , Female , Child , Humans , Down Syndrome/complications , Stomach/pathology , Intestine, Small/pathology , Trichotillomania/complications , Trichotillomania/diagnosis , Abdominal Pain/complications , Bezoars/diagnosis , Bezoars/surgerySubject(s)
Hepatolenticular Degeneration/epidemiology , Adolescent , Anemia, Hemolytic/etiology , Ceruloplasmin/analysis , Chelation Therapy , Child , Child, Preschool , Consanguinity , Copper , Early Diagnosis , Female , Genetic Testing , Hepatolenticular Degeneration/complications , Hepatolenticular Degeneration/diagnosis , Hepatolenticular Degeneration/drug therapy , Hepatolenticular Degeneration/genetics , Humans , Hypertension, Portal/etiology , Liver Cirrhosis/etiology , Male , Morocco/epidemiology , Penicillamine/therapeutic use , Retrospective Studies , Symptom Assessment , Zinc Sulfate/therapeutic useABSTRACT
OBJECTIVE: Esophageal strictures in children are serious and require specialized care. Peptic stricture is most common in our context, whereas caustic and congenital strictures are rare. The present study reports our experience in esophageal endoscopic dilation while specifying the causes of esophageal strictures as well as their response to endoscopic treatment. METHODS: This is a case study during a period of 7 years, in which 60 cases of esophageal stricture were treated with endoscopic dilation by Savary-Gilliard bougies. Our patients were divided into 3 groups: group A for peptic strictures (52 patients), group B for caustic strictures (4 patients), and group C for strictures subsequent to esophageal atresia surgery (4 patients). The age of patients was between 10 months and 17 years. Dysphagia was the main symptom and was the major reason for consultation. Two hundred forty-seven dilation sessions were performed, with an average of 4 sessions per patient ranging from 1 to 15 sessions. The maximum score was observed in group B (50%). Expansion was performed under deep sedation. RESULTS: We had 2 esophageal perforations: 1 in group A and 1 in group B. A good response was obtained in group A (70%) and B (50%). The patients in group C still required repeated sessions. CONCLUSIONS: Esophagus endoscopic dilation is an effective technique, especially in peptic stricture, with no need of surgery in some cases. In addition, perforation was rare in this group.
