Pediatric Radiology

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

Giant gastric bezoar presenting as an acute abdominal emergency

Clinical Image
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

ESM 1

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

References

  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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