A neglected case of trichotillomania presenting with jejunal trichobezoar and intestinal obstruction in Bangladesh: A case report

Trichotillomania, a condition characterized by compulsive hair-pulling, is recognized as an obsessive-compulsive disorder in the DSM-5. Patients suffering from trichotillomania may develop trichobezoar if not treated early. These hair masses typically form in the stomach, but primary bezoars rarely develop in the small bowel without gastric involvement. This case report presents a 13-year-old girl with a two-month history of abdominal pain, vomiting, and a palpable abdominal mass. History-taking revealed an unusual pattern of scalp hair loss for two years and long familial disharmony. Diagnostic imaging showed a foreign body in the jejunum, which was diagnosed as trichobezoar during laparotomy and was removed surgically. This case emphasizes the need for thorough preoperative evaluation in patients with unexplained gastrointestinal symptoms and the critical importance of early recognition and treatment of trichotillomania to prevent severe complications, such as trichobezoar formation. • Trichotillomania can lead to serious complications like trichobezoar formation. • Early diagnosis is crucial in preventing gastrointestinal obstructions. • Imaging techniques like ultrasound and CT are vital for diagnosing bezoars. • Familial disharmony and stress may contribute to compulsive behaviors in children.