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The Old Endoscopy Quiz (and Answer) of the Month
April 2004

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the Quiz Page

Question:

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This young lady had suffered from a slight iron deficiency anaemia for a few years. During the last year she often vomited during the night and has lost some weight. This is the finding during an upper endoscopy. A hughe black mass filled up almost her entire stomach. What is this typical but quite rare finding?

Answer

    Gastric trichobezoar

    Bezoars are foreign peristent bodies of material accumulated in the stomach. A bezoar can consist of different substances.

    Trichobezoars contains human hair and is a result of ingestion of hair, seen most often in young women.

    Phytobezoars are made of vegetable fibers and pharmacobezoars of medications.

    Poor gastric motility can lead to the formation of bezoars. Yeast bezoars is usually a complication of gastric surgery. A bezoar can be asymptomatic or cause diffuse dyspeptic symptoms.

    Treatment if medical if possible (using enzymatic preparations and drugs that enhance gastric motility, e.g. metoclopramide). Large trichobezoars often need surgical treatment.


    High resolution image: Gastric trichobezoar, xray-finding of the bezoar in the endoscopic images above

Correct answers and comments were emailed by

    francesco di stefano, sant'agata li battiati, Italy
    Dr.CSBR.Prasad, Riyadh, CP, Saudi Arabia
    LUISGUILLERMO GUERRERO, BOGOTA, COLOMBIA
    James Churchill, Adelaide, Australia
    Klaudia J.Niepsuj, Bytom, Poland - and as this is written on the night between April 30 and May 1 - a warm Welcome to the European Union! It is some kind of a historical night!
    Salvatore Della Ducata, Gallipoli, Italy
    Maciej Kohut, Katowice, Poland - and as this is written on the night between April 30 and May 1 - a warm Welcome to the European Union! It is some kind of a historical night!
    Sheikh Anwar Abdullah, Kuala Lumpur, Malaysia
    ARBER F. Veliu, Prishtina, KOSOVA
    Petr Vožeh, Praha, Èeská republika - and as this is written on the night between April 30 and May 1 - a warm Welcome to the European Union! It is some kind of a historical night!
    PARABOLI SILVA, Marcio Luiz M.D., Sao Jose do Rio Preto-SP-, SP-BRAZIL
    German Lloret Salom, Alzira, España
    pop octavian, Suceava, Romania
    Christian Nielsen, Uppsala, Sweden
    Hurler, Ulrike, Heidenheim, Germany
    Björn Lindkvist, Malmö, Sweden
    Fonsell Riikka, Helsinki, Finland
    St. Lukes Endoscopy RN's & Techs, Boise, Boise
    Juan C Munoz, Jacksonville, USA/Florida
    Zahreddine Radwan, Beirut, Lebanon ferhat turkmen, erzurum, Turkey
    Dr.S.Sridhar, Augusta, Georgia, USA
    VALLADARES GUILLERMO, LIMA, PERU
    U cuartas, augusta
    Staffan Höstman, Vasa/Uppsala, Finland/Sverige
    Mansour Al Shehadat, Damascus, Syria
    Kremer, Ostrava, CZ - and as this is written on the night between April 30 and May 1 - a warm Welcome to the European Union! It is some kind of a historical night!
    ALTIN CEKODHIMA, TIRANA, ALBANIA
    BASSAM AHMAD MOUSSAWI, NABI CHIT, LEBANON
    balas maria, le mans, France

Comments:

    Interesting finding! Looks like a BEZOAR i.e. a hairball, and a large one for that matter!

    Trichobezoar (Rapunzel's Syndrome)

    The Rapunzel syndrome.Gastric trichobezoar.IT MUST BE SYRGICALLY REMOVED.

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