Pediatric Radiology

, Volume 40, Supplement 1, pp 99–99 | Cite as

Giant gastric bezoar presenting as an acute abdominal emergency

  • Puneet BhargavaEmail author
  • Grace Phillips
Clinical Image


Foam Mental Retardation Neurofibromatosis Neurofibroma Endoscopic Therapy 
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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.
Fig. 1

Supine abdominal radiograph

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


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


  1. 1.
    Lynch KA, Feola PG, Guenther E (2003) Gastric trichobezoar: an important cause of abdominal pain presenting to the pediatric emergency department. Pediatr Emerg Care 19:343–347PubMedCrossRefGoogle Scholar
  2. 2.
    Hewitt AN, Levine MS, Rubesin SE et al (2009) Gastric bezoars: reassessment of clinical and radiographic findings in 19 patients. Br J Radiol 82:901–907PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Department of RadiologyUniversity of WashingtonSeattleUSA
  2. 2.VA Puget Sound Health Care SystemSeattleUSA
  3. 3.Division of Computed TomographySeattle Children’s HospitalSeattleUSA

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