Asperger syndrome in a patient with intestinal obstruction secondary to ileal trichobezoar - Case report

The bezoar is a conglomerate of indigestible or partially digestible foreign material that stagnates in the digestive tract. Cases of primary intestinal trichobezoar, without associated gastric trichobezoar, are rare. Trichobezoar occurs most frequently in patients with mental disorders. We present the case of a patient aged 12 years and 5 months, who was referred to our hospital with the suspicion of intestinal obstruction, the clinical symptomatology consisting of uncontrollable vomiting, cramping abdominal pain and the absence of intestinal transit. Imaging investigations were inconclusive as to the cause of the bowel obstruction. Surgery was performed for mechanical intestinal obstruction and during the exploratory laparotomy an intraluminal formation was revealed in the ileum which after enterotomy was identified as a trichobezoar and other formations in the colon which were manually manipulated towards the distal colon and later evacuated manually by digital rectal palpation. Postoperative pediatric psychiatric evaluation revealed symptoms suggestive of Asperger Syndrome. Our paper, explores the association between tricophagy and pervasive developmental disorders. Although many cases of autistic children ingesting inedible items are described in the literature, there are very rare situations in which pica causes obstruction of the small intestine, requiring surgical intervention.