Pediatric Radiology

, Volume 40, Supplement 1, pp 99–99

Giant gastric bezoar presenting as an acute abdominal emergency

Authors

    • Department of RadiologyUniversity of Washington
    • VA Puget Sound Health Care System
  • Grace Phillips
    • Department of RadiologyUniversity of Washington
    • Division of Computed TomographySeattle Children’s Hospital
Clinical Image

DOI: 10.1007/s00247-009-1511-3

A 13-year-old girl with neurofibromatosis presented to the ER with emesis and anorexia for 3 days. A firm epigastric mass was palpated on physical examination. The rare diagnosis of gastric neurofibroma was suspected. Supine abdominal radiograph demonstrated mottled lucencies distending the stomach and simulating a large, recently ingested meal (Fig. 1). CT revealed a mixed air and soft-tissue density intraluminal gastric mass, confirming the diagnosis of a gastric bezoar (Fig. 2). Subsequently, our patient admitted to habitually ingesting foam and hair. Patient’s IQ was normal.
https://static-content.springer.com/image/art%3A10.1007%2Fs00247-009-1511-3/MediaObjects/247_2009_1511_Fig1_HTML.gif
Fig. 1

Supine abdominal radiograph

https://static-content.springer.com/image/art%3A10.1007%2Fs00247-009-1511-3/MediaObjects/247_2009_1511_Fig2_HTML.jpg
Fig. 2

CT abdomen coronal reconstruction

Up to 90% of trichobezoars occur in girls younger than 20 years. Common associations are mental retardation, pica, and trichotillomania [1]. Gastric bezoars often present with acute symptoms and sometimes respond to conservative or endoscopic therapy [2]. In our patient, the bezoar was removed via open surgery forming a cast of the stomach (Supplementary materials available with this article online).

Supplementary material

View video
ESM 1

Video demonstrating the surgical removal of the bezoar in the operating room. (AVI 7970kb)

Copyright information

© Springer-Verlag 2010