PMC10117021_01
Abdominal ultrasound: Intraluminal material of an ileal loop in the form of a hyperechoic crescent with posterior shadow cone
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F1
An abdominal ultrasound was performed [Figure 1]; it demonstrated an endoluminal hyperechoic arch in a small sub-umbilical loop generating a posterior shadow cone with distension of the upstream hailstones.
Abdomino-pelvic computed tomography scan: Distension of the small-bowel (red arrow) upstream of a hairless, oval endoluminal mass, of heterogeneous density, surrounded by a dense border closing containing air bubbles, unchanged after contrast in relation to the trichobezoar (yellow arrow)
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F2
We completed the assessment by an abdomino-pelvic computed tomography (CT) scan before and after injection of iodinated contrast product (PDC I) [Figure 2]; she objectified a flat colon, a distension of the loops measuring 30 mm in diameter upstream of a transition zone corresponding to an intraluminal formation in a pelvic ileal loop, oval, well delimited by a spontaneously dense border, containing trapped air bubbles.
Abdomino-pelvic computed tomography scan: Gastric trichobezoar (yellow arrows)
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F3
A similar picture was identified in the stomach [Figure 3].
The consequence of hair pulling in the frontal region of the scalp hair
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F4
The re-interrogation has rediscovered the notion of trichotillomania [Figure 4] and trichophagia comforting the diagnosis of trichobezoar.
Gastrotomy and the surgical specimen of the gastric trichobezoar
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F5
The patient was urgently operated; the procedure consisted of removing the small intestine obstacle and the gastric trichobezoar by gastrotomy [Figure 5].