July Case 2017 

Access case here. 

Authors: Avraham Zlochower, MD, PGY-3, Radiology Resident, Staten Island University Hospital - Northwell Health, Staten Island, NY; Jeremy Neuman, MD, Director of Pediatric Radiology, Pediatric Radiology, Department of Radiology, Staten Island University Hospital - Northwell Health, Staten Island, NY; and Varun Mehta, MD, PGY-2, Radiology Resident, Department of Radiology, Staten Island University Hospital - Northwell Health, Staten Island, NY

1. Why did you select this case for submission?

I chose this case since it was a pathology I had only come across in my reading and found the imaging findings and clinical story very compelling.

2. What should readers learn from this case?

I think readers should learn how to recognize a bezoar and to look for potential complications such as perforation or obstruction.

3. What did you learn from working on the case?

I learned about how complicated treating bezoars can be and most patients require surgery. Additionally, since the case was a trichobezoar associated with trichitillomania, there was an additional psychosocial aspect to this case that I do not typically think about in day to day practice.

4. How did guidance from senior staff at your institution impact your learning and case development?

The senior staff at my institution are critical for my learning in all facets. In fact, Dr, Neuman was the attending on call when this case occurred during night float. He was instrumental in guiding me both when the case was happening and when I submitted it to Case in Point.

5. Why did you choose Case in Point for submission of your case?

I chose Case in Point since it is an excellent website showing unique cases that all matter of radiologists can learn from. Our case involved interesting findings on multiple modalities which I thought made it an excellent choice for Case in Point.

6. Are you a regular reader of Case in Point? What are your favorite types of cases?

Yes, I really enjoy cases where the clinical impact is as important as the radiologic findings.

7. What else should we know about the case that you’d like to share?

This case was really a multidisciplinary effort between the Emergence Department, Pediatrics, Surgery and Radiology. The patient had been ill for several months with alopecia but presented with acute abdominal pain. It was the radiologic findings, especially on CT, that was the key for diagnosing and treating the patient emergently.


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