Rapunzel syndrome trichobezoar in a twelve year old girl: a case report

Authors

  • Dharmendra Kumar Pipal Department of General Surgery, Dr. S. N. Medical College, Bhilwara, Rajasthan, India
  • Vibha Pipal Department of Gynaecologist and Obstetrics, AIIMS, Jodhpur, Rajasthan, India
  • Rajendra Pipal Department of Orthopaedics, Government Medical College, Bhilwara, Rajasthan, India
  • Seema Yadav Department of Anaesthesia, Government Medical College, Bhilwara, Rajasthan, India
  • Saurabh Kothari Department of General Surgery, Dr. S. N. Medical College, Bhilwara, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-2902.isj20194081

Keywords:

Trichobezoar, Rapunzel syndrome, Psychiatric female

Abstract

A bezoar refers to a mass of undigestible foreign material found in the gastrointestinal tract, mainly stomach. The second most common bezoar is the trichobezoar, which usually occurs in the young psychiatric female patients with history of trichotillomania and trichophagia. A 12-year-old female psychiatric patient came with complains of diffuse abdominal pain, vomiting, fever, and constipation. Ultrasonography and CT scan were done, which suggested trichobezoar. Thus, trichobezoar should be considered as differential diagnosis of abdominal pain in young psychiatric female patients. In the literature several treatment options are proposed, including removal by conventional laparotomy, laparoscopy and endoscopy. According to our experience and in line with the published results, conventional laparotomy is still the treatment of choice. In addition, psychiatric consultation is necessary to prevent relapses. We here report a case of 12 years old girl presented with complain of vomiting, pain and lump abdomen, loss of appetite and on laprotomy a large, approximately 156 cm trichobezoar was removed which was extending from stomach to ileocaecal junction. Trichobezoar, an underdiagnosed entity, has to be considered in the differential diagnosis of abdominal pain and a non-tender abdominal mass even in young children.

References

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Published

2019-08-28

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Section

Case Reports