Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A case of gastric trichobezoar causing psychiatric problems

정신적 문제로 인한 털위석 1례

  • Seo, Ji Young (Department of Pediatrics, Soonchunhyang University Hospital) ;
  • Kim, Min Young (Department of Pediatrics, Soonchunhyang University Hospital) ;
  • Noh, Jae Ho (Department of Pediatrics, Soonchunhyang University Hospital) ;
  • Kim, Chun Dong (Department of Pediatrics, Soonchunhyang University Hospital) ;
  • Park, Jae Ock (Department of Pediatrics, Soonchunhyang University Hospital) ;
  • Choi, Gyo Chang (Department of Radiology, Soonchunhyang University Hospital)
  • 서지영 (순천향대학교 의과대학 소아과학교실) ;
  • 김민영 (순천향대학교 의과대학 소아과학교실) ;
  • 노재호 (순천향대학교 의과대학 소아과학교실) ;
  • 김춘동 (순천향대학교 의과대학 소아과학교실) ;
  • 박재옥 (순천향대학교 의과대학 소아과학교실) ;
  • 최교창 (순천향대학교 의과대학 영상의학과학교실)
  • Received : 2009.04.23
  • Accepted : 2009.09.11
  • Published : 2009.10.15
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Abstract

Trichobezoar is characterized by the accumulation of hair in the gastrointestinal tract and usually occurs in those who have trichotillomania, other psychiatric disorders, or neurologic problems. Trichobezoar typically presents as gastric obstruction, including abdominal pain, vomiting, anorexia, and weight loss. A 9-year-old girl visited our clinic with the complaint of abdominal discomfort and vomiting. A review of her medical history revealed that she had trichophagia since the age of 5, and she felt that her parents had been strict with her. She underwent gastrotomy, during which a large trichobezoar was removed. This case highlights the importance of psychiatric and comprehensive approaches in patients with trichobezoar.

털위석은 위장관에 털이 축적되어 생기며, 발모광이나 다른 정신적인 문제나 신경학적인 문제가 있는 환자들에게서 주로 발생한다. 털위석은 복통, 식욕부진, 구토 같은 위장관 폐쇄의 증상들로 나타난다. 국내외에서 위석의 보고는 식물위석에 대한 것이 대부분이며, 털위석이 소아에게서 보고된 경우는 많지 않다. 9세 여아가 복부 불쾌감과 복부 종괴로 내원하였다. 환아는 5년 전부터 머리카락을 주어먹는 버릇이 있었고 부모로부터 오빠에 대한 차별적인 대우를 받는다고 생각하였으며 학교에서 성적은 뒤처지는 편이지만 그 외 특별한 병력은 없었다. 복부 컴퓨터단층촬영술을 시행하여 위 안에 거대한 털위석을 확인하였으며, 위절개술을 시행하여 털위석을 제거하였다. 그 후 정신과적인 상담과 치료를 권유하였으나 보호자의 거부로 중단되었다. 이에 저자들은 정신적인 문제가 수반된 환아가 복부 증상으로 내원시 털위석의 유무에 대한 접근과 진단의 중요성을 강조하는 바이다.

Keywords

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