Bezoar in Pediatrics: Case Series and Literature Review

Introduction: Bezoars are accumulations of indigestible material within the gastrointestinal tract, which, although rare, can lead to significant intestinal obstruction, especially in pediatric patients. This condition often necessitates not only surgical intervention to remove the obstruction but also a multidisciplinary approach to address underlying psychological issues due to the high recurrence risk associated with compulsive disorders. This study presents a series of cases involving children under 14 years old who experienced intestinal obstruction from bezoars and were treated at a tertiary care public hospital, complemented by a literature review to enhance understanding of this condition. Case Series: This descriptive case series study reviews three pediatric patients who underwent surgical treatment for intestinal obstruction caused by bezoars over the past two years. Results: The study identified three patients, all under 14 years of age, who required surgical intervention for bezoar-related intestinal obstruction. Among them, two were male and one was female. Two patients had trichobezoars (66.7%), located one in the stomach and one in the jejunum, while the remaining patient had a phytobezoar (33.3%) in the jejunum. Surgical treatment involved conventional laparotomy with exploration and two-layer enterorrhaphy in all cases. Discussion: Bezoars are categorized into four types: phytobezoars (plant material), pharmacobezoars (medications), lactobezoars (milk products), and trichobezoars (hair). Trichobezoars are most common in the studied cases, contrasting with existing literature that suggests a higher frequency of other types. Bezoars typically present with gastric symptoms but may also cause small intestine obstruction in about 10% of cases. The management of bezoars usually requires endoscopic or surgical removal, with psychological follow-up recommended due to high recurrence rates. The study emphasizes the importance of thorough surgical exploration for concurrent bezoars and integrating psychological care into treatment plans. Conclusion: Bezoars, although rare, are a serious concern in the pediatric population due to their potential to cause significant gastrointestinal obstruction. Effective management requires not only the surgical removal of the bezoar but also consideration of psychological factors to prevent recurrence. This case series highlights the need for a comprehensive approach, including psychological support and detailed surgical exploration, to optimize patient outcomes.