Gastric bezoar must be included in differential diagnosis because it may simulate clinical symp- toms of malignancy, especially if a palpable mass or anemia is present. These symptoms are related to large trichobezoar, which may virtually occupy the entire stomach and proximal duodenum (Rapunzel syndrome), causing irritation of the gastric mucosa, secondary gastric ulcers, and anemia. Surgical removed or extracorporeal shock way lithotripsy is indicated.

Effectiveness of Coca-Cola lavage for children with gastric Phytobezoar has been proven