TRICHOTILLOMANIA, TRICHOPHAGIA AND TRICHOBEZOAR - AN INTERESTING CASE REPORT

Trichotillomania is the condition of voluntarily pulling ones own hair. Trichophagia is consumption of hair. Trichobezoar is a compact mass of hair, occupying the gastric cavity to a various extent. Although trichotillomania as such may not be serious, untreated trichophagia secondary to trichotillomania is a potentially life-threatening condition. Patient was a 7 year old girl who reported with complaints of repeated hair pulling and eating hair for 2 years, abdomen pain for 15 days. Investigations by imaging, revealed a solid mass in abdomen which was later confirmed to be hair by endoscopy. On examination, hair loss was evident in scalp. Patient revealed some thoughts of wanting to pull hair and consume them but there was no clarity in them. Patient was diagnosed a case of Trichotillomania with Trichobezoar and was posted for surgery. Surgical removal of a significant mass of hair was done. After post operative recovery, behaviour therapy was initiated. Patient was regularly followed up in psychiatry OP and there was a good response to therapy but after few months patient did not come for follow up. This case reveals that trichotillomania with trichophagia can lead to emergency situations due to formation of trichobezoar. A better understanding of the factors influencing this illness is essential to identify and treat trichotillomania before the advent of serious complications.