Trichobezoars in children

Eight children with trichobezoar are reported. In seven cases the trichobezoar was confined to the stomach and duodenum. In one case it was present only in the small and large bowel. Age and sex incidence, clinical manifestations, diagnosis and treatment are discussed. It is suggested that one should suspect trichobezoar when a child, especially a girl, presents with a firm mobile lump in the epigastrium.

Spontaneous tuberculous enteroumbilical fistulas

Gastrointestinal tuberculosis in children is an uncommon condition. Obstruction and hemorrhage are the known common complications of tuberculous enteritis. Perforation is an uncommon complication whereas tubercular enterocutaneous fistula is a still rarer complication. Five children with spontaneous tubercular enteroumbilical fistulas are being reported. All were below the age of 10 years, the youngest being 15 months old. Four children had conservative treatment with antitubercular drugs and one had exploration, resection of gut and excision of fistula. All the children who had conservative treatment survived whereas the child who underwent surgery died in the postoperative period. We feel that the conservative management is the treatment of choice in cases of established tubercular enterocutaneous fistulas.