From trichophagia to trichobezoar: Rapunzel syndrome in a child - A case report and literature review.

Abstract

Background: Gastric trichobezoars are suggestive of Rapunzel Syndrome, a rare condition typically affecting young women with underlying psychosis. Patients show trichotillomania and trichophagia, which, over time, produce a stomach trichobezoar. This mass may develop a characteristic tail-like protrusion in the small intestine.

Relevance: Rapunzel Syndrome should be considered in the differential diagnosis, given its rarity and variations in symptoms among individuals. Early identification helps to avoid misdiagnosis, aggravation of the illness, and inadequate therapy plans.

Case presentation: A 7-year-old female patient presented with a severe stomachache, weight loss, and trichophagia. A physical examination revealed a lump in the epigastric area, an intragastric mass, and mild hepatomegaly. Jejunojejunal intussusception with mesenteric lymphadenopathy was verified with a contrast-enhanced abdominal CT scan, which is a key unique presentation of this case. A successful laparotomy was performed, and a wound infection with E.coli and Candida species after surgery was treated with Amikacin and dressing.

Discussion: From being asymptomatic to generating major difficulties, Rapunzel Syndrome shows a wide spectrum of symptoms. This disorder causes bacterial or fungal infections in many people; hence, recurrence is often seen in those who neglect mental consultations. Treatment plans differ; endoscopy is appropriate for some situations, but more severe cases call for surgical intervention.

Conclusion: Trichobezoar is an unusual illness that, if not identified on time, can result in serious medical complications. An accurate diagnosis depends on a complete examination, appropriate history-taking, and early investigations. To prevent relapse, psychiatric follow-up is crucial, and laparotomy is still the gold standard technique.