Searching for a Lead: Diagnosing a Rare Cause of Recurrent Intussusception

A 5-year-old girl with a history of insomnia and developmental delays presented with recurrent intussusception, bilious emesis, and abdominal pain. Initial imaging and laparoscopy failed to identify a lead point, but exploratory laparotomy revealed a trichobezoar causing the intussusception. The trichobezoar was surgically removed, resolving her symptoms. The patient was diagnosed with trichotillomania and trichophagia, conditions often associated with developmental and psychiatric disorders. Post-surgery, she received psychiatric evaluation and therapy, leading to weight gain and cessation of hair ingestion. This case highlights the importance of considering trichobezoars in differential diagnoses for pediatric abdominal pain, especially in patients with developmental or psychiatric histories.