Rare abdominal pain in adolescents: case series and review
Journal name: World Journal of Pharmaceutical Research
Original article title: A rare and unusual presentation of abdominal pain in young adolescents. case series and review
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Waseem Raja, Rohey Jan, Rifat Khan, Sabiya Gul, Hilal Wani, Salma Maryam
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World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: A rare and unusual presentation of abdominal pain in young adolescents. case series and review
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Doi: 10.20959/wjpr20173-7959
Copyright (license): WJPR: All rights reserved
Summary of article contents:
Introduction
Trichobezoars are rare yet significant causes of acute abdominal pain, particularly in young adolescents with psychiatric conditions. A trichobezoar is a type of bezoar formed from ingested hair, commonly associated with mental health disorders such as trichotillomania (compulsive hair pulling) and trichophagia (compulsive hair eating). This article reports two case studies: one involving a 16-year-old female patient with a trichobezoar and another concerning an 18-year-old male who ingested metallic nails. The condition poses challenges for diagnosis and treatment, necessitating a comprehensive understanding of its etiology and management strategies.
Understanding Trichobezoars
Trichobezoars, a specific type of bezoar, arise from the ingestion of hair, leading to accumulations in the gastrointestinal tract. These formations can cause serious complications, including gastric obstruction and ulceration. In young patients, especially females, trichobezoars are often linked to psychiatric conditions like trichotillomania and trichophagia. Symptoms may include abdominal pain, weight loss, and other gastrointestinal complaints. Diagnosis is typically confirmed through imaging studies and endoscopy, which can reveal the presence of a distinctive mass in the stomach.
Case Study: Female Patient with Trichobezoar
One notable case involved a 16-year-old girl who was admitted with recurrent abdominal pain, vomiting, and significant weight loss. Clinical assessment revealed patchy alopecia, indicative of a possible psychiatric disorder. Imaging studies suggested a bezoar, which was later confirmed through endoscopy as a large mass of hair occupying the gastric cavity. Surgical intervention was required to remove the trichobezoar, followed by psychiatric evaluation and treatment. After six months, the patient showed significant improvement and no further gastrointestinal symptoms.
Case Study: Male Patient with Ingested Metal
The second case presented an 18-year-old male with recurrent abdominal pain and hemetemesis. Upon investigation, it was discovered that he had ingested multiple metallic nails, a behavior stemming from his mental retardation and seizure disorder. Endoscopic removal of the metallic objects was successful and without complications. This case highlights the unique challenges presented by patients with psychiatric conditions who may present with gastrointestinal symptoms due to harmful ingestive behaviors.
Conclusion
Trichobezoars and foreign body ingestion are important causes of abdominal pain that require keen clinical awareness, especially in adolescents with psychiatric disorders. prompt diagnosis and treatment are vital to avoid serious complications. The cases discussed underscore the significance of considering psychiatric history when evaluating gastrointestinal complaints in young patients. There is a need for ongoing research to better understand the underlying psychiatric conditions and improve intervention strategies for these vulnerable groups.
FAQ section (important questions/answers):
What is a trichobezoar and who is most affected by it?
A trichobezoar is a mass of ingested hair in the gastrointestinal tract, occurring predominantly in young psychiatric females with conditions like trichotillomania and trichophagia.
What symptoms may indicate a trichobezoar in a patient?
Symptoms include recurrent abdominal pain, weight loss, vomiting, alopecia, and gastrointestinal obstruction signs. Patients may also present with microcytic hypochromic anemia.
How are trichobezoars diagnosed and confirmed?
Diagnosis begins with imaging, such as ultrasound or CT scans, followed by endoscopy, which confirms the presence of trichobezoars in the stomach.
What are the treatment options for trichobezoars?
Treatment options include endoscopic removal, surgical excision, and sometimes enzyme therapy, depending on the size and nature of the bezoar.
What potential complications can arise from trichobezoars?
Complications may include gastrointestinal obstruction, ulceration, bleeding, and in severe cases, perforation of the stomach or intestines.
Why is early diagnosis important for trichobezoars?
Early diagnosis and intervention can prevent serious complications and improve the patient's outcomes, as symptoms can escalate without timely treatment.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Rare abdominal pain in adolescents: case series and review”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Hair:
Hair plays a crucial role in the formation of trichobezoars, which are indigestible masses found in the gastrointestinal tract. In cases of trichophagia, individuals consume their own hair, leading to the accumulation of hairballs in the stomach, resulting in various gastrointestinal issues such as abdominal pain and obstruction.
2) Pain:
Pain is a significant symptom associated with familial disorders like trichobezoars. The organism experiences abdominal pain resulting from the obstruction caused by the mass in the gastrointestinal tract. Understanding the cause of abdominal pain is vital for proper diagnosis and management of conditions like trichobezoars in young patients.
3) Srinagar:
Srinagar is relevant as it is the location of the Government Medical College where the authors conducted their study. As a city in Jammu & Kashmir, it serves as a healthcare hub, providing insights into local cases of trichobezoar and facilitating research on rare medical conditions in that region.
4) Vomiting:
Vomiting is a common symptom in patients with trichobezoars. It occurs as the gastrointestinal tract becomes obstructed by indigestible materials. In this context, it is essential for healthcare professionals to investigate the underlying causes of vomiting, especially in young patients to determine if there’s a presence of a bezoar.
5) Bleeding:
Bleeding or hematemesis can occur in cases with severe gastrointestinal obstruction, such as multiple metallic objects found in the stomach. Understanding the mechanisms of bleeding due to ulcers or erosions created by foreign bodies highlights the need for timely diagnosis and intervention to prevent further complications.
6) Nature:
Nature relates to the inherent characteristics and complexities of medical conditions like trichobezoars. This includes understanding their formation, associated symptoms, and treatment options. A comprehensive view of the patient's natural habits, including hair consumption, is essential to diagnosing and managing such rare gastrointestinal diseases.
7) Male:
The relevance of 'Male' highlights that trichobezoars predominantly occur in females, though male cases exist. Understanding gender-related differences in these disorders can assist healthcare professionals in recognizing risk factors, as well as designing targeted approaches for effective diagnosis and treatment for both males and females.
8) Swallowed:
Swallowed refers to the act of ingesting hair and foreign bodies, which can lead to trichobezoar formation. In patients with eating disorders or psychiatric conditions, such actions can result in severe abdominal issues, illustrating an important connection between behavior and gastrointestinal health that practitioners should monitor.
9) Medicine:
Medicine encompasses the field of healthcare that addresses conditions like trichobezoars. This includes the diagnosis, treatment, and management of symptoms associated with this rare gastrointestinal condition. A thorough understanding of medical practices is necessary to prevent and treat complications effectively arising from trichobezoars.
10) Kashmir:
Kashmir is the broader geographic location which includes Srinagar. It is significant for understanding regional health issues, access to medical facilities, and the demographics of the patients affected by conditions like trichobezoars. The unique socio-cultural context of Kashmir may influence the prevalence of psychiatric-related disorders.
11) Filling (Filled):
Filled indicates the condition of the stomach in patients with trichobezoars where the gastrointestinal tract is occupied by indigestible material like hair. This finding is crucial in imaging studies, informing clinicians of the extent of obstruction and guiding further diagnostic and surgical interventions.
12) India:
India is important as the country where the documented cases of trichobezoars were reported. The study reflects on healthcare challenges, particularly in rural areas, and sheds light on the need for increased awareness and education regarding gastrointestinal issues linked to psychiatric conditions affecting young individuals.
13) Raja:
Raja, as part of the author’s name, reflects the research contribution of Dr. Waseem Raja in the field of gastroenterology. His findings and case studies on trichobezoars enhance medical literature and support the understanding of this rare condition, thereby influencing future medical practice.
14) Sign:
Sign refers to the clinical manifestations associated with trichobezoars, including abdominal pain, weight loss, and vomiting. Recognizing these signs is essential for healthcare professionals in identifying potential cases, leading to timely interventions to mitigate complications resulting from such gastrointestinal blockages.
15) Young girl:
Young girl specifies the demographic often affected by trichobezoars, particularly in the context of psychiatric disorders like trichotillomania and trichophagia. Understanding this demographic helps tailor educational and therapeutic approaches to prevent the onset of such conditions, ensuring better health outcomes and awareness.
16) Accumulation (Accumulating, Accumulate):
Accumulate pertains to the gathering of indigestible substances in the gastrointestinal tract, leading to conditions such as trichobezoars. Understanding the underlying causes of this accumulation—such as psychiatric conditions—helps in developing preventive strategies and treatment modalities for at-risk populations.
17) Observation:
Observation involves monitoring patients for symptoms associated with trichobezoars after initial diagnosis. Continued observation is vital for assessing the effectiveness of treatment plans, understanding patient progress, and preventing further complications arising from persistent gastrointestinal issues linked to these conditions.
18) Discussion:
Discussion emphasizes the need for open dialogues among medical professionals regarding the diagnosis and management of trichobezoars. Such discourse enriches the understanding of the condition and enables sharing of best practices, leading to improved patient care and reduced incidences of overlooked cases.
19) Knowledge:
Knowledge underscores the importance of understanding the etiology, symptoms, and management strategies for conditions like trichobezoars. Expanding medical knowledge through research ensures that healthcare providers can deliver effective care, leading to better patient outcomes and reduced complications from these gastrointestinal masses.
20) Swelling:
Swelling may refer to the distension of the abdominal cavity due to the presence of a trichobezoar. Recognizing signs of abdominal swelling is crucial for diagnosis, as it may indicate serious underlying conditions that necessitate immediate medical attention.
21) Disease:
Disease in this context refers to medical conditions like trichobezoars which result from various psychological factors. Understanding these diseases is essential for developing effective treatment options and support systems for patients, especially in recognizing and addressing psychiatric conditions underlying the onset of disorders such as trichophagia.
22) Family:
Family implicates the necessary involvement of patients' relatives in understanding and treating conditions like trichobezoars. Support from family members is crucial for recognizing symptom patterns and assisting in managing psychiatric conditions, which can significantly affect treatment success.
23) Nausea:
Nausea is a common symptom in patients with trichobezoars, often stemming from gastrointestinal distress caused by obstruction. Identifying nausea in patients helps healthcare professionals assess the severity of the condition and determine the most appropriate interventions to alleviate discomfort.
24) Reason:
Reason pertains to the understanding of why individuals may develop conditions leading to trichobezoars, including psychiatric disorders. Identifying these underlying reasons is vital for healthcare professionals in creating effective treatment plans and preventive measures for individuals at risk.
25) Debate:
Debate highlights the ongoing discussions in the medical community regarding best practices for diagnosing and treating conditions like trichobezoars. Engaging in these debates enhances the understanding of emerging treatments, leads to improved clinical guidelines, and ultimately benefits patient care.
26) Animal:
Animal is significant in understanding the broader biological context of bezoars, as similar conditions can occur in animals. Studying bezoars across species helps researchers identify shared pathophysiological mechanisms, which can inform human medical research and treatment strategies.
27) Soura:
Soura is relevant as it identifies the specific locality of SKIMS, where one of the authors works. Understanding the healthcare context in Soura provides insight into regional medical practices, patient demographics, and prevalent health issues within that area.
28) Ulcer:
Ulcer relates to the potential complications that can arise from the presence of trichobezoars in the stomach, such as gastric ulcers. Understanding the link between trichobezoars and ulcer formation is important for diagnosis and treatment, ensuring timely intervention to prevent severe outcomes.
29) Fever:
Fever might indicate underlying infections or systemic reactions related to gastrointestinal issues, including trichobezoars. Recognizing fever as a symptom can inform healthcare professionals of possible complications, guiding them to conduct further investigations and appropriate management.
30) Blood:
Blood is crucial in diagnosing conditions associated with gastrointestinal issues, such as the presence of hematemesis linked to trichobezoars. Monitoring blood parameters helps in assessing the severity of the condition and guiding treatment options to prevent further complications.
31) Study (Studying):
Study refers to the systematic examination of cases related to trichobezoars, enhancing comprehension of their clinical presentation, management, and outcomes. Conducting comprehensive studies contributes to the overall medical knowledge base, facilitating more effective diagnosis and treatment approaches in the future.
32) Sweating (Sweat):
Sweat may relate to the physiological responses in patients experiencing gastrointestinal stress due to conditions like trichobezoars. Understanding the correlation between physical responses and underlying conditions allows healthcare professionals to better assess and manage the overall health of their patients.
33) Food:
Food is relevant to the context of trichobezoars because the masses form from ingested materials that mix with hair. A proper understanding of dietary habits among individuals, especially those with trichophagia, is crucial for prevention and intervention strategies to avoid gastrointestinal complications.
34) Pose:
Pose signifies the potential risks associated with trichobezoars and their treatment. Understanding the complications and challenges that arise, such as surgical risks or delayed diagnosis, is essential for developing effective management strategies that address both the condition and the associated consequences.
35) Milk:
Milk is included in the discussion of bezoars, as it can lead to the formation of lactobezoars in infants. Recognizing the different types of bezoars underscores the importance of considering dietary sources when diagnosing gastrointestinal obstructions and planning appropriate treatment.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Rare abdominal pain in adolescents: case series and review’. Further sources in the context of Science might help you critically compare this page with similair documents:
Abdominal pain, Surgical excision, Gastrointestinal Tract, Diagnostic management, Weight loss, Mental Retardation, Rehabilitation therapy, Endoscopy, Psychosomatic condition, Obstructive symptoms, Young adolescents, Trichobezoar, Gastroenterology division.