Rapunzel syndrome: the pathway for a prompt diagnosis

Antunes, Henedina; Barroso, Catarina; Faria, Catarina; Correia‐Pinto, Jorge

doi:10.1136/archdischild-2018-315910

Cited by 8 publications

(10 citation statements)

References 2 publications

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“…Of the 17 trichophagia cases, 3 female patients had trichobezoars found. Cases of trichobezoars are most commonly reported in females [12]. Those families that note trichophagia in their children should be aware of the accompanying complications such as abdominal and epigastric pain, ulcerations, gastric mucosal erosion, and, in severe cases, death [13].…”

Section: Discussion/conclusionmentioning

confidence: 99%

Trichotillomania in Children and the Different Approaches between Dermatological and Behavioral Health Professionals at an Urban Tertiary Care Center

Rangu

Castelo‐Soccio

2020

Skin Appendage Disord

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Background: Trichotillomania (TTM) is a complex disease with varying clinical characteristics, and psychosocial impairment is noted in many TTM patients. Despite its prevalence in childhood, there is limited research on pediatric TTM. Objective: To analyze the clinical and epidemiologic features of TTM in children evaluated by dermatologists and behavioral health specialists. Method: We performed a retrospective chart review of 137 pediatric patients seen at the Children’s Hospital of Philadelphia with initial presentation of TTM at age 17 or younger. Patients were treated by dermatology or behavioral health. Results: The majority of the patients were females, with an average diagnosis age around 8 years. Over half had a psychiatric comorbidity, and over a quarter had a skin disorder. Skin disorders were more commonly present in those evaluated by dermatology, and psychiatric comorbidities were more commonly present in those evaluated by behavioral health. The most common form of treatment was behavioral therapy, with medications prescribed more often by dermatologists. Conclusions: TTM patients choose to present to behavioral health or dermatology; however, there are distinctive differences between the two cohorts. With behavioral and pharmacologic treatment options, a relationship between dermatologists and behavioral health specialists is necessary for multifactorial management of TTM.

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Section: Discussion/conclusionmentioning

confidence: 99%

Trichotillomania in Children and the Different Approaches between Dermatological and Behavioral Health Professionals at an Urban Tertiary Care Center

Rangu

Castelo‐Soccio

2020

Skin Appendage Disord

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“…A bezoar is an accumulation of indigestible foreign material in the gastrointestinal tract that forms a mass. Trichobezoars (masses formed by compressed hair) are well defined within the human and veterinary literature and are the most common type of bezoar due to the resistance of hair to digestion and peristalsis . In humans, trichobezoars are typically the result of trichotillomania and trichophagia .…”

Section: Introductionmentioning

confidence: 99%

“…Trichobezoars (masses formed by compressed hair) are well defined within the human and veterinary literature and are the most common type of bezoar due to the resistance of hair to digestion and peristalsis . In humans, trichobezoars are typically the result of trichotillomania and trichophagia . Trichobezoars have been reported in many non‐human primate species including the chimpanzee, baboon, rhesus macaque, tamarin, and galago…”

Section: Introductionmentioning

confidence: 99%

Mineralized Trichobezoars in a Rhesus Macaque (Macaca mulatta)

Wilson

Wallace

Brice

et al. 2020

J of Medical Primatology

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“…At an early stage, most trichobezoars are asymptomatic or may present with subtle symptoms such as nausea or early satiety [24]. As trichobezoar enlarges, it may present with the signs and symptoms of acute abdomen and gastric tract obstruction which include abdominal pain, nausea, bilious vomiting, hematemesis, anorexia, early satiety, weakness, weight loss and abdominal mass, depending on the degree of obstruction [8,10,12,15].…”

Section: Introductionmentioning

confidence: 99%

“…The intervention practices comprise of endoscopy, laparoscopy or laparotomy [6,10,11,24,26]. A further rare complication of Rapunzel syndrome leads to gastric perforation [24,25].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Surgical Extraction of Large Gastric Trichobezoars: A Single Center Study of Two Cases

Saggar¹,

Saggar²

2020

IJG

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Trichobezoars are compact mass of hair occupying the gastric cavity that if left untreated can cause developmental delay, malnutrition, obstruction or perforation. The treatment options include extraction by conventional laparotomy, laparoscopy, gastrotomy or endoscopy. Since they are almost always associated with trichotillomania and trichophagia or other psychiatric disorders, psychiatric consultation is necessary to prevent relapses. We reviewed the medical charts of two patients with trichobezoar who were treated at Lord Mahavir, Civil Hospital, Ludhiana. Both the cases, aged 14 and 19 years were females and presented at the hospital with a history of epigastric discomfort, pain and vomiting. Both the girls were lean, underweight and pale skinned. First patient had trichotillomania and trichophagia for 1 year prior to presentation. The parents were unaware of patient's trichophagia but the girl revealed that she ate hair during the night. The second patient had no history of trichophagia and the bilateral loss of scalp hair indicated nocturnal involuntary eating of hair during sleep. The large palpable mass in both the cases was non-tender, hard, smooth and mobile on examination. The abdominal imaging with CT revealed the mass occupying most of the gastric cavity, and turned out to be trichobezoars. The masses were successfully extracted by laparotomy and gastrotomy. A trichobezoar represents a serious surgical condition. It is important to consider such diagnosis in face of suggestive symptoms, even if signs of trichotillomania are not present. Gastrotomy was found to be very successful for the surgical removal of trichobezoars. The behavioral assessment and psychiatric counselling also plays a useful role in patient management and prevention of recurrence.

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Rapunzel syndrome: the pathway for a prompt diagnosis

Cited by 8 publications

References 2 publications

Trichotillomania in Children and the Different Approaches between Dermatological and Behavioral Health Professionals at an Urban Tertiary Care Center

Trichotillomania in Children and the Different Approaches between Dermatological and Behavioral Health Professionals at an Urban Tertiary Care Center

Mineralized Trichobezoars in a Rhesus Macaque (Macaca mulatta)

Diagnosis and Surgical Extraction of Large Gastric Trichobezoars: A Single Center Study of Two Cases

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