Child with small bowel obstruction and perforation secondary to ileal bezoar.

Bezoars are a rare cause of intestinal obstruction, but morbidity and mortality of late diagnosis and complication are high. Generally, bezoars remain in the region of the stomach; however, infrequently, they will pass to the small bowel. The clinical diagnosis of bezoar is challenging, and initial radiographs are frequently nondiagnostic. Early recognition of this entity on plain film or by computed tomography is important to prevent late complications. In addition, bezoar formation can indicate underlying psychiatric disorder that requires evaluation and therapy. We present a child with classic radiographic trichobezoar that had passed to the distal ileum and resulted in subsequent perforation.