1 - Cirurgia Pediátrica, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
- Oral presentation - 8ª reunião da EUSPP e 23º congresso da SPCP
Clinical report: A 11-year-old girl, with history of attention deficit hyperactivity disorder and compulsive obsessive disorder, presents to the ED with a 5-day history of bilious vomiting, constipation and abdominal bloating. The patient was dehydrated, with abdominal distention, generalized abdominal pain and a palpable abdominal mass on the right lower quadrant. Blood work was normal. Abdominal X-ray presented air-fluid levels, and the abdominal ultrasound was compatible with an ileocecal intussusception. Exploratory laparotomy was performed, finding a free ileocecal valve and two palpable masses on the distal ileum. After enterotomy, two cylindrical trichobezoars where extracted. The patient was discharged 5 days later and a psychiatric evaluation was request.
Discussion: The diagnosis of intestinal trichobezoar is difficult due to the similarities with other intra-intestinal masses. Ileocecal intussusception is a differential diagnosis, being more prevalent in the pediatric age. The abdominal TC can be helpful in distinguishing the origin of an intra-intestinal obstruction.
Conclusion: Trichobezoar induced intestinal occlusion should be considered as a differential diagnosis in young women with psychiatric history. Abdominal TC, although not performed frequently in the pediatric population, can be helpful to establish a diagnosis. Prevention of recurrence of trichotillomania should be the long-term goal.
Palavras Chave: trichobezoar