A 25-year-old woman with clinical depression was referred with vague epigastric pain and early satiety after meals for 6 months. Abdominal examination revealed an indentable J-shaped mass in the epigastrium. A barium meal examination was subsequently carried out.

The image shows a whorled, stippled mass occupying the stomach, forming a ‘J’ shape. The most likely diagnosis was a trichobezoar. Bezoars are of different kinds and commonly include hair (trichobezoar), vegetable fibres (phytobezoar) or medications (pharmacobezoar). About 90% of bezoars are encountered in women, and about 10% of these patients have a psychiatric disorder.

The patient underwent exploratory laparotomy with gastrotomy and removal of a large hairball, which had an extension into the duodenum.