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Endoscopic shaving of hair in a gastric bypass patient with a large bezoar
  1. Waseem Amjad1,
  2. Gautham Upadhya2,
  3. Abu Hurairah3,
  4. Shahzad Iqbal4
  1. 1Internal Medicine, Northwell-Long Island Jewish Forest Hills Hospital, Allama Iqbal Medical College, Forest Hills, New York, USA
  2. 2Internal Medicine, Brookdale University Hospital and Medical Center, Brooklyn, , New York, USA
  3. 3Department of Gastroenterology, SUNY Downstate Medical Center, New York, USA
  4. 4Department of Gastroenterology, Island Gastroenterology Consultants, West Islip, New York, USA
  1. Correspondence to Dr Waseem Amjad, waseemonline001{at}


Trichotillomania can be associated with the formation of trichobezoars (hair ball) usually located in the stomach. Trichobezoars may lead to complications including bowel obstruction, and perforation. Patients with a history of diabetes, certain psychiatric disorders, prior gastric surgery and poor mastication ability are at an increased risk of developing bezoars. We are presenting a case of patient who suffered from a large, recurrent trichobezoar, who had a history of gastric bypass surgery as well as trichotillophagia. The endoscopic method used to remove the large bezoar will also be discussed. We have reviewed the cases published, in which patients developed bezoars after undergoing gastric bypass surgery. The purpose of this study is to raise awareness among clinicians that patients with certain psychiatric issues who had prior gastric surgeries, are at eminent risk of bezoar formation. A multidisciplinary approach including cognitive behavioural therapy, dietary education and pharmacotherapy should be taken to prevent complications.

  • endoscopy
  • eating disorders
  • Gastrointestinal Surgery
  • stomach and duodenum

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  • Contributors SI gave the idea and framework. WA and GU wrote the manuscript and AH read the manuscript and gave the inputs.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.