Bulky gastroduodenal trichobezoar (Rapunzel syndrome) causing abdominal pain and anorexia in a nine-year-old female
Authors:
M. Geryk 1; E. Karásková 1; T. Malý 2; M. Velgáňová-Véghová 1; B. Ludíková 1; J. Čivrný 3; J. Volejníková 1,4
Authors‘ workplace:
Dětská klinika, Lékařská fakulta Univerzity Palackého a Fakultní nemocnice, Olomouc
1; I. chirurgická klinika, Lékařská fakulta Univerzity Palackého a Fakultní nemocnice, Olomouc
2; Radiologická klinika, Lékařská fakulta Univerzity Palackého a Fakultní nemocnice, Olomouc
3; Institut molekulární a translační medicíny Univerzity Palackého, Olomouc
4
Published in:
Čes-slov Pediat 2021; 76 (5): 257-261.
Category:
Case Report
Overview
Here we present a case of a nine-year old female admitted due to nonspecific abdominal pain and anorexia (specifically, rejecting solid food). History of a long-term psychological burden was reported, leading to trichotillophagia and a presence of hair in the stool. On physical examination, palpable bulky resistance located in the epigastrium was revealed. Gastroscopy identified a large rigid trichobezoar in the stomach, extending down to the duodenal bulb. Due to its size, endoscopic removal of the hairball was not possible and a laparotomy-gastrotomy with extraction of a cast trichobezoar was performed, followed by revision of the small intestine. Approximately 6 months after the surgery, the patient was diagnosed with chronic gastritis and required antibiotic eradication of Helicobacter pylori. Continuous psychological and psychiatric care improved the overall condition of the patient and prevented the recurrence of trichotillophagia. This case report is aimed to highlight the possibility of bezoar as an extremely rare cause of abdominal pain in children, thus complementing its broad differential diagnosis.
Keywords:
Abdominal pain – children – anorexia – gastrotomy – Rapunzel syndrome – trichobezoar (hairball) – trichotillophagia
Sources
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Labels
Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2021 Issue 5
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