Minerva: August 2002

A young woman aged 16 presented with iron deficiency anaemia and a palpable mass the size of an orange in the left upper quadrant of her abdomen. An ultrasound scan showed a distended abdomen with no abnormality. This led us to investigate further with a barium meal (top), which indicated a trichobezoar (hair ball of the stomach). The trichobezoar formed a cast of the stomach and was removed at laparotomy (bottom). The patient made a good recovery and was discharged from the clinic four months later. Anorexia nervosa is spreading frighteningly in Western countries. Its classified as deliberate weight loss and is a progressive ‘pursuit of lightness.’ Looking at contexts where lightness is celebrated—in music, literature and the arts—one writer suggests anorexic behaviour is much more than a pattern of psychiatric symptoms. Instead, he says, it should be thought of a meaningful behaviour expressing ethical values deeply rooted in Western culture ( Medical Humanities 2002;28:3 8). Haemodialysis patients say they notice poor saliva production, which can be distressing. In an effort to identify the most important factors associated with stimulated salivary flow, 50 …