PMC8170345_01
Hair loss in the patient.
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Very sparse hair was noted throughout his scalp (Figure 1).
Upper GI with fluoroscopy.
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Given this new piece of information, feeding intolerance, and exam findings of hair loss, an Upper gastrointestinal (GI) with fluoroscopy was performed and showed a 4.2 x 1.8 cm mobile filling defect in the gastric lumen, concerning for a gastric bezoar (Figure 2).
Endoscopic image of bezoar.
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An endoscopy was performed to assist with removal of the bezoar through his G-tube, and the patient was found to have a 10 cm x 3 cm gastric bezoar consisting of hair, nail, and food material (Figure 3).
Removed trichobezoar.
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After removal of the trichobezoar (Figure 4), the patient showed improvement in his fussiness, he was able to tolerate feeds without discomfort, and began to show consistent weight gain.