Trichobezoar — An unusual cause of megaloblastic anemia and hypoproteinemia in childhood

A case of gastric bezoar in a 6-year-old child is discussed. The child presented with megaloblastic anemia due to vitamin B12 deficiency. In addition, hyperfolatemia and hypoalbuminemia were demonstrated. A combination of low B12 and markedly elevated serum folate in the presence of megaloblastic anemia suggests bacterial overgrowth within the upper small bowel. The implications of this combination of findings on the operative procedure for removal of the bezoar are discussed.