Author(s): Nagendra Prasad Anipindi1

Trichobezoar is collection of hairs forming a conglomerated mass. It is a very rare entity mimicking other common causes of gastric outlet obstruction. It is classically seen in adolescent females usually with psychiatric disturbances. Stomach is the most common site of occurrence. Occasionally, it may extend into small intestine (Rapunzel syndrome). Patients present with nonspecific symptoms such as loss of appetite, early satiety and vomiting. It may present as failure to thrive in small children. Diagnosis is frequently delayed due to paucity of symptoms. It is noticed as a slowly growing lump but occasionally may present with complications such as perforation, intestinal obstruction and pancreatitis. Abdominal ultrasonography is inconclusive and upper gastrointestinal endoscopy confirms the diagnosis. Laparotomy and extraction is the standard of treatment in spite of many new minimally invasive techniques. This is a case of gastric trichobezoar in a 16-year-old girl who presented with gastric outlet obstruction, which was successfully removed surgically. Recurrences are frequent due to associated psychiatric disturbances, hence psychiatric counselling must form an integral part of treatment.

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