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Special Feature
April 1998

Radiological Case of the Month

Arch Pediatr Adolesc Med. 1998;152(4):404. doi:

Figure 1. Abdominal radiographs reveal multiple dilated loops of small bowel on the left side of the abdomen with a "coiled-spring" appearance.

Figure 2. Trichobezoar represented as an intraluminal filling defect in the stomach with an associated jejunojejunal intussusception.

Figure 3. Specimen of trichobezoar with a long tail.

Bezoars consist of nondigestible foreign material present in the stomach or intestine and are categorized by content. Phytobezoars originate from vegetable and plant matter, trichobezoars result from the ingestion of hair, and trichophytobezoars are a collection of material from both categories but do not result from hairy fruit. Many other materials form intragastric concretions including gum, Gummi-bears (a type of chewy candy), popcorn kernels, sunflower seeds (when eaten with their shells), vitamins, aluminum hydroxide, magnesium hydroxide, bulk laxatives, sucralfate for antacid therapy, slow-release forms of nifedipine and procainamide hydrochloride, enteric-coated aspirin, and ion exchange resin.1-4 There is an article reporting a bezoar formed from debris originating from a pancreatic pseudocyst following a Roux-en-Y gastrojejunostomy.5 Unripened persimmons, known for the formation of phytobezoars, contain soluble tannin called "shibuol" that, on coming into contact with a weak acid, forms a gluey coagulum affixing other matter present in the stomach.6