TRICHOBEZOAR VENTRICULI IN 7-YEAR OLD GIRL – CASE REPORT

Gastric trichobezoar presents a compact mass of undigested hair inside a ventricular cavity. „Bezoar“ is the name of Arab origin and denotes an antidote, which was the result of a belief that animal stomach stone had a healing feature (Shorter 2005). Forming of a trichobezoar is a rare medical condition. In literature, the majority of presented cases are ones of female adolescents (Jain et al. 2011), there are just a few case reports of preadolescents. Forming of a trichobezoar is usually a result of hair swallowing (trichophagia). In one third of the patients with trichophagia, its result is forming of a trichobesoar (Salaam et al. 2005). Trichophagia as part of pica disorder, can be a reflection of severe neglect and lack of parental supervision (Rose et al. 2000). Depending on the different authors, it is estimated that 5-20% of people with trichophagia also have a compulsive need for pulling out their own hair (trichotillomania) (Grant & Odlaug 2005). Trichotillomania is a psychiatric impulse control disorder (Colomb et al. 2011), and according to DSM-5 classification falls within spectrum of obsessive compulsive disorders (American Psychiatric Association 2013). Trichotillomania is usually connected to hair pulling, but eyebrow, eyelashes and pubic region hair pulling can also be present (Gaw owska-Sawosz 2016). Different authors mention other psychiatric conditions connected to forming of a trichobesoar: mental retardation, obsessive compulsive disorder, depression and anorexia nervosa (Cohen et al. 1995). Trichobezoar can easily be diagnosed by endoscopic examination or computed tomography (CT), and the therapy almost always requires surgical removal (Mewa Kinoo & Singh 2012). The diagnosis of trichobesoar represents an etiologic and therapeutic challenge, and requires a multidisciplinary approach (Santos et al. 2012). Therapy and prevention also involve the participation of several consultants, paediatrician, surgeon, child psychiatrist, Clinic’s social worker and the Community Social Service. The aim of the case report is to show the importance of multidisciplinary medical approach and role of child psychiatrists in the therapy of trichotilomania, prevention of trichobezoar, as well as in the occurrence of relapses. CASE REPORT