Rapunzel Syndrome: How to Orient the Diagnosis

Finale, Enrico; Franceschini, P; Danesino, Cesare; Barbaglia, Michelangelo; Guala, Andrea

doi:10.4081/pr.2018.7689

Cited by 11 publications

(13 citation statements)

References 8 publications

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“…In some cases, however, the trichobezoar extends through the pylorus into jejunum, ileum, or even colon. This condition, called Rapunzel syndrome, was first described by Vaughan et al in 1968 2,9 .…”

Section: Discussionmentioning

confidence: 99%

Gastric trichobezoar: An uncommon cause of epigastric pain: A case report

Daoud

Tlili

Fendri

et al. 2022

Clinical Case Reports

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Trichobezoars are foreign and indigestible materials in the gastrointestinal tract and are usually found in psychiatric females, who often deny eating their own hair, but also at situations of gastric dysmotility and prior gastric surgery. Although rare, gastric trichobezoar should not be forgotten as a differential diagnosis in females presenting with vague epigastric pain. Its treatment well in time will prevent complications.

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Section: Discussionmentioning

confidence: 99%

Gastric trichobezoar: An uncommon cause of epigastric pain: A case report

Daoud

Tlili

Fendri

et al. 2022

Clinical Case Reports

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show abstract

“…Trichobezoar is a compact conglomeration of swallowed hair and makes up less than 6% of all Bezoars [6] , [7] . It often occurs in children with mental retardation and it is seen as early as the age of 3 years [8] .…”

Section: Clinical Discussionmentioning

confidence: 99%

Trichobezoar: A case report of a double gastric and ilial localization revealed by an occlusion

Khalifa

Ghannouchi

Nacef

et al. 2022

International Journal of Surgery Case Reports

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Introduction and importance A bezoar is an agglutination of ingested materials forming an indigestible and insoluble mass inside the gastrointestinal tract. Trichobezoars formed by ingested hair are rare. The stomach tends to be the typical location. In some cases there is an extension to the duodenum, jejunum or even to the colon and it is called Rapunzel syndrome. Case presentation We present a case of an occlusion due to double trichobezoars in 17 years old woman who underwent an extraction by enterotomy and gastrotomy. Clinical discussion Trichobezoar is a compact conglomeration of swallowed hair and makes up less than 6% of all bezoars. It appears in young women under 20 years of age who carry psychiatric or chronic metabolic diseases that can alter the behavioral balance. Physical examination is often poor in uncomplicated forms: forms without peritonitis or occlusion or hemorrhage or appendicitis or pancreatitis but it may reveal a well-limited, smooth, firm, and mobile epigastric mass. For uncomplicated forms or forms complicated by hemorrhage, the reference examination requested in the first line remains the esophagogastroduodenoscopy (EGD) which allows a dual role both diagnostic and therapeutic. Computed Tomography (CT) remains the preferred imaging modality requested urgently in case of an occlusion or peritonitis presentation. Endoscopic extraction represents the therapeutic approach for uncomplicated forms but surgical treatment remains the main therapeutic means of trichobezoar. Conclusion Trichobezoars are rare and present both diagnostic and therapeutic challenge. Laparotomy remains the most successful surgical treatment although laparoscopy currently appears to have promising results in expert hands. A post-operative pscychologic management is essential to correct psychobehavioral disorders of patients to prevent recurrence.

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“…Trichobezoar formation is estimated in 1% of patients suffering from hair eating (trichophagia). 4 Hair-pulling disorder (trichotillomania) affects approximately 0.6-3.6% of the population of the USA, and is classified among the obsessive-compulsive disorders according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. 5 Recurrent pulling of hair results in hair loss, inhomogeneous scalp distribution, damaged straggly and thinning hair, and areas of bald scalp, not attributed to dermatological or other mental (e.g.…”

Section: Discussionmentioning

confidence: 99%

Chewing gum bezoar as an unexpected cause of acute intestinal obstruction

Sinopidis

Zachos²,

Panagidis³

et al. 2020

J Paediatrics Child Health

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An impaction formed of undigested foreign bodies or nutrients in the gastrointestinal tract is called a bezoar (Arabic: bazahr, Persian: padzehr, antidote). 1,2 Bezoars collected from animal stomachs were used as antidotes for poisons and therapies for numerous maladies, until Baudament in 1779 became the first to consider them as a cause of human disease. 1 A bezoar may occur at any part of the gastrointestinal tract, more frequently in proximal segments (stomach and duodenum). 3 The most familiar type is the trichobezoar (Greek: tricha, hair) of the stomach, occurring most commonly in patients younger than 30 years (80%), who are mainly (90%) young females who swallow their hair. 1,2 The phytobezoar type (Greek: phyto, plant) formed by vegetable fibre concretions is most commonly located in the small bowel of children. 2 Other types are caused by milk (lactobezoar), food boluses and medications (i.e. antacids). 1,3 Among the more uncommon causes of bezoar formation are candies, chewing gum included, with only a handful of cases reported in children.A 12-year-old female patient presented with acute abdominal pain and bile-stained vomiting. Abdominal plain radiography in upright position showed distended small bowel loops with airfluid levels (Fig. 1). A bolus of 300 mL of bilious content passed Key Points 1 In a child with gastrointestinal distress, do not omit to include swallowing and chewing habits in history. 2 It is a myth that bezoars occur mainly in mentally impaired children. The majority occur in healthy children. 3 The paediatrician should consult the parents on their child's swallowing and chewing habits and advise them to try to prevent their children swallowing candy or chewing gum.

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Rapunzel Syndrome: How to Orient the Diagnosis

Cited by 11 publications

References 8 publications

Gastric trichobezoar: An uncommon cause of epigastric pain: A case report

Gastric trichobezoar: An uncommon cause of epigastric pain: A case report

Trichobezoar: A case report of a double gastric and ilial localization revealed by an occlusion

Chewing gum bezoar as an unexpected cause of acute intestinal obstruction

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