Abstract

Background: Mixed bezoars, comprising multiple types of indigestible materials within the gastrointestinal tract, are particularly rare in children.
Case presentation: A 9-year-old girl with a history of chronic constipation and pica (ingestion of hair, rubber bands, dried nail polish, and seeds) presented with weight loss, poor oral intake, and recurrent bilious vomiting. Physical examination revealed abdominal distension and a palpable mass in the right upper quadrant. Computed tomography revealed a significant intragastric bezoar. She underwent exploratory laparotomy and complete bezoar removal, with no postoperative complications. Multidisciplinary follow-up included psychiatric evaluation and nutritional guidance.
Conclusion: This case highlights the importance of a high index of suspicion for bezoars in pediatric patients presenting with unexplained abdominal masses, vomiting, or weight loss, especially in those with behavioral risk factors such as pica.

Key words: Mixed bezoar, Pica, pediatric, abdominal mass, trichobezoar, case report.