![]() ![]() Unusual cause of palpable mass in upper abdomen-giant gastric trichobezoar: report of a case. Pogorelić Z, Jurić I, Zitko V, Britvić-Pavlov S, Biocić M. Gastric trichobezoar: an important cause of abdominal pain presenting to the pediatric emergency department. Review of the diagnosis and management of gastrointestinal bezoars. Iwamuro M, Okada H, Matsueda K, Inaba T, Kusumoto C, Imagawa A, Yamamoto K. Since many of these patients suffer from psychiatric pathology such as PICA with emotional problems and mental retardation, psychological/psychiatric counselling plays an important role in order to prevent bezoar recurrence.Ībdominal pain Case report Iron deficiency anemia PICA Rapunzel syndrome Trichobezoar Trichophagia Trichotillomania. Gradual re-feeding with supplementation of micronutrients allows adequate catch-up weight with normalization of haematochemical nutritional parameters. A prompt diagnosis and an appropriate therapy can reduce comorbidities. The Rapunzel syndrome is a rare entity that may be complicated by life-threatening events. The patient passed through a gradual re-feeding, with iron and vitamins supplementation, and through a psychiatric counselling. As the bezoar couldn't be removed by endoscopy, the girl underwent surgical intervention. Since trichobezoar has an extension to the small bowel, it is classified as Rapunzel syndrome. To underline the importance of including this pathology in the differential diagnosis of IDA and abdominal pain, we present the case of a 14 year-old girl with a huge trichobezoar which completely filled the stomach and extended into the small bowel. ![]() When undiagnosed, gastric bezoars may cause gastric ulceration, perforation, haemorrhage and obstruction. Trichobezoar is an under-diagnosed entity that has to be considered in children and adolescents, expecially female, suffering from trichotillomania (compulsion to pull hair) and trichophagy (compulsion to swallow hair). They are manifestations of a wide variety of diseases ranging from benign to immediately life-threatening. Iron deficiency anemia (IDA) and abdominal pain are commonly seen in a pediatric emergency department (8 and 18% incidence respectively in our center).
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