The Diagnosis of Trichobezoar Based on the Presence of Hypercholesterolemia: A Case Report.

Trichobezoar refers to the collection of ingested hair accumulating in the gastric mucosa folds, which are found in patients with trichotillomania and trichophagia. We present a case of a nine-year-old girl in Japan who was found to have hypercholesterolemia in the universal lipid screening as a part of the annual health checkups for the prevention of lifestyle-related diseases. Further examination revealed a palpable mass without any digestive symptoms. Imaging studies and the patient's history of pica indicated trichobezoar and upper gastrointestinal endoscopy revealed a large hairball occupying the entire lumen of the stomach. Thereafter, the large trichobezoar was removed by laparotomy and psychological support was provided to her to prevent its recurrence. Hypercholesterolemia improved after the removal of trichobezoar, which suggests an association between a large trichobezoar and cholesterol metabolism. Hypercholesterolemia may serve as a clue to the identification of trichobezoar.