Stitieh, Youmna

ABSTRACT The term “trichobezoar” refers to foreign and indigestible material in the gastrointestinal tract, and it can indicate several underlying mental illnesses. A 38‐year‐old woman reported experiencing sudden intensive abdominal pain, along with a two‐month history of vomiting, nausea, exhaustion, and abdominal discomfort. The diagnosis of gastrointestinal perforation was validated by investigations. During an emergency laparotomy, a perforated stomach ulcer with enormous trichobezoar occupying the entire gastric lumen was revealed. The giant trichobezoar was removed, along with the appendix. The pathology report revealed serositis, fibrosis, and active chronic Helicobacter pylori gastritis. Trichobezoar exhibits variation in locations and volumes. These frequently starts with minimal symptoms but over time can produce nausea, vomiting, peritonitis, hematemesis, abdominal pain, or even perforation, especially in patients who are at risk of developing ulcers and have a large trichobezoar.

Introduction and importance: Cor triatriatum sinister (CTS) is an uncommon heterogeneous congenital cardiac defect that may manifest in adulthood when symptomatic blockage manifests due to a change in hemodynamic physiology or when a condition such as atrial fibrillation (AF) arises. The incidence of cor triatriatum with cardiomyopathy and congenital heart illness ranges from 0.1 to 0.4%. Case presentation: The Department of Cardiology examined a 10-year-old girl for a diastolic murmur. The patient’s medical history was ordinary, and no previously known co-morbid illnesses were present. Pneumonia was the patient’s original medical condition. A cardiac murmur was also discovered during the physical examination, and the patient was forwarded for more research. Physical examination revealed just a diastolic murmur, which was noteworthy. The patient’s care plan includes routine echocardiographic monitoring. Since the deformity was not clinically significant, surgical repair was not advised. Clinical discussion: It is unclear what caused this flaw. A full, incomplete, or fenestrated septum may be the result of the common pulmonary vein failing to merge with the left atrium during embryonic development. The existence of a fibromuscular membrane, which separates the left atrium (LA) into two chambers—the proximal chamber receiving the pulmonary veins (PVs) and the distal chamber contains the mitral valves and LA appendages defines the disease. Conclusion: The diagnostic procedure should be carried out in the optimal settings, however, in cases of frail health systems, employing accessible alternatives might help the early diagnosis. Early referral to a cardiologist is required in case of CTS suspicion.