Rare gastric bezoar in a school-aged child: a paediatric diagnostic conundrum.

A healthy toddler presented with a 1-month history of constipation and was started on laxatives. Four years later, the patient returned with an abdominal mass and pain, but no vomiting, diarrhoea or hard stools. An ultrasound showed a thickened hyperechoic wall with acoustic shadowing in the epigastric region and enlarged mesenteric lymph nodes. Routine laboratory tests were normal. Laxatives were reintroduced, and a follow-up ultrasound 3 months later still indicated an abdominal mass. Five months afterwards, the CT scan suggested a bezoar, leading to a referral to the paediatric surgical unit. A month later, an MRI scan strongly suggested a trichobezoar. Surgery was performed 4 months later, revealing a large trichobezoar in the stomach. The patient has been well postoperation. We outline the epidemiology, key investigations and management options for these lesions. Furthermore, this report emphasises the importance of early suspicions of bezoars, advanced imaging techniques and a multidisciplinary approach in management.