Bezoar-related stercoral perforation in an 11-year old child: Has anyone seen my other sock?

• Bezoars classically occur in young females with psychiatric disturbances.
• Major constituents are hair or vegetable fibers but other materials can contribute.
• Stercoral perforations, often associated with constipation, may result from bezoars.
• Pica will rarely be volunteered by a patient or family.
• A broad differential is required to thoroughly evaluate pediatric abdominal pain.

Bezoars are accretions of indigestible material that develop within the gastrointestinal tract and occur with relative infrequency. Rarer yet, stercoral perforations of the colon (SPC) result from pressure-induced ischemia and are nearly universally associated with chronic constipation. We report only the second recorded case of a bezoar-related stercoral perforation of the colon, the first to result from ingestion of cloth, and the first in a pediatric patient.