Trichophagia as a cause of acute appendicitis in a patient with bipolar disorder

Acute appendicitis is one of the most common abdominal surgical emergencies worldwide. Clinical diagnosis is possible in most of the cases although imaging modalities may become necessary if the diagnosis is uncertain. Appendectomy, preferably the laparoscopic approach, still remains the gold standard treatment to date. The pathophysiology usually includes luminal obstruction by an appendicolith or lymphoid hyperplasia and rarely parasitic infections. In this report, we present an extremely rare case of a patient with diagnosis of bipolar disorder and a history of trichophagia resulting in trichobezoar formation within the appendiceal lumen leading to acute appendicitis.