Trichobezoar (hairball) causing acute intestinal obstruction in a child aged three years.

Although not uncommon in mental hospital patients, a trichobezoar in a child is not often seen. Besides being rare, the condition is of considerable historical interest. The word 'bezoar,' derived from Arabic ' badzehr' or from Persian 'pad zahr,' signifying counter-poison or antidote, is the term applied to masses found in the intestine and stomach of both men and animals. Bezoars have been known since the twelfth century B.C. They were supposed to have marvellous medicinal and mystical properties ; and this was the belief as late as the eighteenth century A.D., Tinct. Bezoardio being included in the materia medica. Such was the considered value of bezoar that many counterfeits were made. To offset this trade, elaborate tests, as futile as the bezoar, were formulated to differentiate true from false (Eusterman and Balfour, 1937). Bezoars which are found in human beings are classified as trichobezoar (hairball) ; trichophytobezoar (ball of hair and vegetable fibre); phytobezoar (ball of vegetable fibre) ; and concretion. The first real case was described by Baudement in 1779 ; and the first reported removal by operation was in 1883 (Schwartzman, 1937). These foreign bodies may produce no symptoms, but those most commonly found are epigastric pain, nausea, vomiting and diarrhoea. A palpable tumour may be present, and the most important aid in diagnosis, according to Eusterman and Balfour (1937), is the radiological examination. By using barium, a non-opaque foreign-body in the stomach is outlined. When found in children, trichobezoar is usually in the stomach.