A rare outcome of iron deficiency and pica: Rapunzel syndrome in a 5-year-old child

Abstract

Bezoar is defined as the accumulation of organic or nonbiological substances inside the gastrointestinal system. Trichobezoars are the most frequently detected ones and are mostly present in patients with neuropsychiatric disorders. The continuance of the trichobezoar tail-shaped extension over the duodenum and jejunum is described in Rapunzel syndrome. Both conditions are rarely reported in children. The present case submitted here is related to a 5-year-old girl referred with an abdominal mass and anemia, diagnosed with Rapunzel syndrome and developing trichobezoar due to iron deficiency and pica.

Trichobezoar in the absence of trichotillomania: a consequence of occupational hazard

“…8 Trichophagia and trichobezoar are abundantly described in surgical literature. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] In majority of the literature trichotillomania and trichophagia has coexisted with trichobezoar.…”

“…9 In few cases, no evidence of trichotillomania was found in patients presenting with trichobezoar. 10,11 Trichobezoar should be considered as a differential diagnosis in young females who present with non-specific symptoms such as epigastric pain, fatigue, weight loss and epigastric mass.…”

Non-obstructive Giant Gastric Trichobezoar: A case of Rapunzel Syndrome

“…Gastric bezoars must be considered as one of the probable diagnosis in a child or an adolescent patient who has a palpable mass in the left upper quadrant 5 .…”

“…Although, it is not a specifi c fi nding, a mild anemia and leucocytosis may accompany the condition 5 . In the cases with obstructive symptoms, there may be fl uid and air levels in plain fi lms 6 .…”

A rare cause of mechanical intestinal obstruction: Pharmacobezoar

“…They are classified depending on the material of origin. A pharmacobezoar is foreign material that is formed by drugs (1)(2)(3). Pharmacobezoar is a very rare condition that may lead to complications (4).…”