CASE REPORT   

Journal of Radiological Review 2022 March;9(1):24-8

DOI: 10.23736/S2723-9284.21.00140-2

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Trichobezoar obstructive syndrome in a pediatric patient: the Rapunzel Syndrome

Alessia DE FEO ¹, Salvatore MIRESSI ¹, Iolanda CAPALDO ¹ ✉, Stefano CALABRESE ¹, Sonia TAMASI ², Rosanna MAMONE ², Giovanni GAGLIONE ², Paolo QUITADAMO ², Massimo ZECCOLINI ²

¹ AOU Federico II, Naples, Italy; ² AORN Santobono-Pausilipon, Naples, Italy

Trichobezoars are masses, which are commonly encountered in patients with psychiatric problems such as trichotillomania and trichophagia, formed by the accumulation of intraluminal nondigestible substances causing the formation of a foreign body within the lumen that can lead to obstruction of the stomach and the small bowel. Rapunzel Syndrome (RS) refers to a very rare syndrome that occur in children. It is a severe condition of a gastric trichobezoar with a long tail that passes into the duodenum and can migrate to the small bowel causing obstruction. Large trichobezoars, including those in Rapunzel Syndrome, can only be managed with open surgical extraction. Here, we present the case of a young patient with an autism spectrum disorder associated with trichotillomania and trichophagia, who presented with gradual loss of appetite and occasional vomiting about six weeks apart and was admitted at Emergency Room with abdominal pain.

KEY WORDS: Bezoar; Trichotillomania; Autistic disorder; Surgical procedures, operative