title: Unusual trichobezoar of the stomach and the intestine: a case report.
abstract: BACKGROUND
  Trichobezoars are an infrequent form of bezoar found in the stomach or intestine, created from ingested hair. This condition has been well described in the surgical literature, but less reported in psychiatry.
  
  
  METHODS
  We describe the case of an 18-year-old Middle Eastern Caucasian woman with trichotillomania who presented to our emergency department with a history of central abdominal pain associated with vomiting and constipation for five days. An examination showed a trichobezoar requiring emergent surgical intervention, and indicating the need for psychiatric treatment. The trichobezoar was treated successfully by laparotomy.
  
  
  CONCLUSIONS
  The medical and psychiatric sequelae of trichotillomania should not be underestimated, and early diagnosis and treatment is of utmost importance to save the patient's life and prevent recurrence. Although laparotomy is still considered an excellent option, pharmacotherapy and behavioral assessment play a useful role in patient management. Our case highlights the fundamental concept of a holistic approach rather than only treating the symptoms, by considering factors such as genetic influences to understand the disease.
authors.forename: Issam S
authors.initials: IS
authors.lastname: Al-Janabi
authors.forename: Muthanna A
authors.initials: MA
authors.lastname: Al-Sharbaty
authors.forename: Marwan M
authors.initials: MM
authors.lastname: Al-Sharbati
authors.forename: Laith A
authors.initials: LA
authors.lastname: Al-Sharifi
authors.affiliation: Department of Genetics, College of Medicine, Sultan Qaboos University, Muscat, Oman. aouhtit@squ.edu.om.
authors.forename: Allal
authors.initials: A
authors.lastname: Ouhtit