Fatal case of Rapunzel syndrome in neglected child

Matějů, Eva; Duchaňová, Svatava; Kováč, Peter; Moravanský, Norbert; Spitz, Daniel J.

doi:10.1016/j.forsciint.2009.05.008

Cited by 21 publications

(16 citation statements)

References 12 publications

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“…A rare presentation of this Trichobezoar is the "Rapunzel syndrome" in which the tail of the hairball extends into the intestines and can cause intestinal obstruction. Rapunzel syndrome and trichobezoar are more common in neglected children (Chamberlain et al, 2007;Mateju, Duchanova, Kovac, Moravansky, & Spitz, 2009;Pul & Pul, 1996;Sah et al, 2008;Ventura, Herbella, Schettini, & Delmonte, 2005).…”

Section: Complicationsmentioning

confidence: 99%

Trichotillomania (hair pulling disorder): Clinical characteristics, psychosocial aspects, treatment approaches, and ethical considerations

França

Kumar

Castillo

et al. 2018

Dermatologic Therapy

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Trichotillomania (hair pulling disorder) is a fairly common but underreported disorder characterized by recurrent episodes of pulling hair from different parts of the body. Currently classified in Diagnostic and Statistical Manual of Psychiatric Disorders (DSM-5) under the heading of the "Obsessive-compulsive spectrum and related disorders." The estimated prevalence data suggest that 0.5-2% of the general population suffers from this disorder. Stress and anxiety are directly correlated to the production of trichotillomania symptoms. The psychosocial aspects of trichotillomania are greatly underestimated, but recent literature suggests an increased interest in this neglected area. Although no FDA approved medications are available for the treatment of trichotillomania, a variety of medications including N-acetylcysteine have shown benefit in case reports. Combined liaison clinics, with an interdisciplinary approach, are highly advisable in the treatment of these cases.

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Section: Complicationsmentioning

confidence: 99%

Trichotillomania (hair pulling disorder): Clinical characteristics, psychosocial aspects, treatment approaches, and ethical considerations

França

Kumar

Castillo

et al. 2018

Dermatologic Therapy

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“…Most patients present with abdominal pain, nausea, and vomiting and, therefore, it is an important diagnosis to consider in this setting. They can even rarely cause peritonitis and perforation [2], [9], [10], [11], [12], [13], [14]. The clinical scenario is most common in teenage girls with the diagnosis in a child very rare.…”

Section: Discussionmentioning

confidence: 99%

“…The syndrome is predominately found in females and can be associated with trichotillomania (the compulsive urge to pull one’s own hair out). Many patients who present with this syndrome have other significant mental or behavioral disorders including neglect, family discord, and bereavement [1], [2]. Rapunzel syndrome, first documented in 1968, can be described as a trichobezoar starting in the stomach and extending into the small intestine.…”

Section: Introductionmentioning

confidence: 99%

Trichobezoar presenting as a gastric outlet obstruction: A case report

Nwankwo

Daniele

Woller

et al. 2017

International Journal of Surgery Case Reports

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HighlightsSeven year old girl presents with abdominal pain, nausea, and vomiting consistent with a gastric outlet obstruction.History of trichotillomania but no observed behavior since 4 years of age.On imaging, concern for trichobezoar extending into the duodenum.Exploratory laparotomy with removal of 18 cm by 18 cm mass of hair through gastrotomy.Clear, high quality intra-operative photographs showing gastrotomy and trichobezoar.

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“…This may cause death from airway obstruction, intestinal obstruction and perforation with peritonitis and generalized sepsis [76]. Individuals with Rapunzel syndrome from compulsive eating of hair (trichophagia) have trichobezoars extending from the stomach to the small intestine that may be associated with gastric perforation and death [77,78]. The ingestion of other foreign material is usually only seen in individuals with mental impairment or psychiatric conditions.…”

Section: Miscellaneousmentioning

confidence: 99%

Death by food

Byard

2017

Forensic Sci Med Pathol

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Although death from food is not an uncommon finding in forensic facilities worldwide, the range of underlying lethal mechanisms and associated conditions that should be sought at the time of autopsy is quite disparate. Deaths may occur from i) infectious agents including bacteria, viruses, protozoa, cestodes, nematodes and prions; ii) natural toxins including amanita toxins, tetrodotoxin, ciguatera and scombroid; iii) anaphylaxis; iv) poisoning; v) mechanical issues around airway and gut obstruction and/or perforation; and vi) miscellaneous causes. Food-related deaths are important in terms of global mortality, and thus autopsies need to be comprehensive with full ancillary testing. Medicolegal matters may involve issues concerning likely exposure to infectious agents, possible foods ingested, the declared content and possible components of food, the significance of toxicological analyses, and aspects of duty of care in cases of café coronary syndrome and gastroenteritis while in care.

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Fatal case of Rapunzel syndrome in neglected child

Cited by 21 publications

References 12 publications

Trichotillomania (hair pulling disorder): Clinical characteristics, psychosocial aspects, treatment approaches, and ethical considerations

Trichotillomania (hair pulling disorder): Clinical characteristics, psychosocial aspects, treatment approaches, and ethical considerations

Trichobezoar presenting as a gastric outlet obstruction: A case report

Death by food

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