Trichotillomania, trichophagia, trichobezoar - summary of three cases. Endoscopic follow up scheme in trichotillomania.

AIM

Trichotillomania is a lack of control of one's hair pulling. It is estimated that about 1% of population develops trichotillomania. In up to 20% of patients with trichotillomania swollowing follows hair pulling. Trichobezoar forms in about 30% of patients with trichofagia.

MATERIAL AND METHODS

In 2008-2014 3 patients were operated on trichobezoar. One patient has had a history of trichotillomania. On admission abdominal X-ray and ultrasonography revealed abdominal mass. Diagnosis was confirmed in abdominal computed tomography.

RESULTS

All three trichobezoars were evacuated from the intestinal tract during laparotomy with wide gastric wall opening. In one case - Rapunzel syndrome - hair mass was evacuated also from the duodenum and small bowel. All patients were referred to psychiatrist after finishing of the surgical treatment.

CONCLUSIONS

In patients operated for trichobezoar as well as other patients with trichotillomania control of hair accumulation in the gastrointestinal tract remains a problem. Authors propose endoscopic follow up scheme in 6, 12, and 24 months after the surgery as well as for other patients with trichotillomania.