Large trichobezoar associated with misdiagnosis, a rare case report with a brief literature review

Trichobezoar is a rare disorder that almost exclusively affects young females. Up to 90% between 13 and 20 years of age. The current study aims to report and discuss a rare case of Misdiagnosis of Trichobezoar. A 18-year-old girl student patient admitted to the Baxshin hospital, with a large trichobezoar filling the entire stomach with a long tail of hair extending within the pylorus into the proximal jejunum at a length of 70 cm; associated with abdominal pain, constipation, and vomiting. Laboratory data showed mild iron deficiency anemia, with a normal liver, and renal function test, patients' electrolytes showed a normal profile. Confirmation of the presence of the mass was done through abdominal Computed Tomography (CT) with contrast. The physician initially diagnosed as alopecia and suspected the abdominal pain was related to the postprandial emesis because the patient didn't provide a history of trichotillomania and used treatment for alopecia for a long time. The presence of a mass in the abdomen of a child is considered one of the most severe findings. Physical examination of the patient plus a full history taken, and the age of the patients provide a clear clue to the origin of the mass. Further investigation, including laboratory data and imaging findings, provides better understanding and a firm diagnosis. Trichobezoar should be considered by the physicians in this case. In the early diagnosis of the trichobezoar, the physicians should investigate for any medical history of clinical trichophagia, trichotillomania, or a psychological problem. •The initial step of trichobezoar diagnosis is a direct question about consuming hair.•Trichobezoar formation is caused by a delay in diagnosing trichotillomania and trichophagia.•Physicians should investigate for any medical history of trichophagia, trichotillomania, or a psychological problem.•The clinical feature of trichobezoar usually associated with alopecia of the scalp and other regions of the body