ArticleBMC pediatrics2018
Rapunzel syndrome: an infrequent cause of severe iron deficiency anemia and abdominal pain presenting to the pediatric emergency department.
Article in BMC pediatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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17 citing papers in PubMed, 38 citations in OpenAlex.
- Trapped In Transit - A Case Report of a Pediatric Gastric Bezoar Causing Intermittent Small Bowel Obstruction.Journal of education & teaching in emergency medicine · 2026Article
- Pediatric case of trichobezoar leading to gastric perforation.Radiology case reports · 2026Article
- Rapunzel Syndrome in a Pediatric Female Patient: A Case Report of Trichobezoar Causing Intestinal Obstruction.Cureus · 2026Article
- From trichophagia to trichobezoar: Rapunzel syndrome in a child - A case report and literature review.International journal of surgery case reports · 2025Article
- Trichobezoar as an Unusual Cause for Iron Deficiency Anemia: A Rare Case Report.Clinical case reports · 2025Article
- Untangling rapunzel syndrome: A unique presentation of gastric trichobezoar.International journal of surgery case reports · 2025Article
- Gastroduodenal Obstruction Secondary to Pica-associated Bezoar: A Case Report.Clinical practice and cases in emergency medicine · 2025Article
- Rapunzel Syndrome: Clinical, Diagnostic and Forensic Aspects in Related Deaths-A Review of the Literature.Journal of clinical medicine · 2024Review
- Rapunzel syndrome in children: a retrospective review of ten cases combined with literature review in a tertiary referral center.Pediatric surgery international · 2024Article
- Giant Gastric Trichobezoar: Unveiling the Complexity of a 14-Year-Old's Abdominal Pain.Case reports in surgery · 2024Article
- Article
- Rapunzel Syndrome in a Teenage Girl: A Case Report.Cureus · 2022Article
- Rapunzel syndrome complicated with pancreatitis, intussusception and intestinal perforation.BMJ case reports · 2022Article
- Rapunzel syndrome with cholangitis and pancreatitis - A rare case report.Open medicine (Warsaw, Poland) · 2020Article
- An Unusual Case of Hypoproteinemia in Childhood: Keep in Mind Trichobezoar.Frontiers in pediatrics · 2020Article
- Trichobezoar as a cause of pediatric acute small bowel obstruction.Clinical case reports · 2020Article
- Large gastric trichobezoar causing failure to thrive and iron deficiency anaemia in an adolescent girl: a case report emphasising the imaging findings and review of the literature.BJR case reports · 2019Article
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8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIron deficiency anemia (IDA) and abdominal pain are commonly seen in a pediatric emergency department (8 and 18% incidence respectively in our center). They are manifestations of a wide variety of diseases ranging from benign to immediately life-threatening. 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). When undiagnosed, gastric bezoars may cause gastric ulceration, perforation, haemorrhage and obstruction. CASE PRESENTATION: 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. Since trichobezoar has an extension to the small bowel, it is classified as Rapunzel syndrome. As the bezoar couldn't be removed by endoscopy, the girl underwent surgical intervention. The patient passed through a gradual re-feeding, with iron and vitamins supplementation, and through a psychiatric counselling.
conclusionThe Rapunzel syndrome is a rare entity that may be complicated by life-threatening events. A prompt diagnosis and an appropriate therapy can reduce comorbidities. Gradual re-feeding with supplementation of micronutrients allows adequate catch-up weight with normalization of haematochemical nutritional parameters. 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.
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