1. Rapunzel syndrome: how to orient the diagnosis
- Author
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Enrico Finale, Cesare Danesino, Andrea Guala, Michelangelo Barbaglia, and Piergiorgio Franceschini
- Subjects
Ectodermal dysplasia ,medicine.medical_specialty ,diagnosis ,lcsh:Medicine ,Case Report ,Pediatrics ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Surgical removal ,Rapunzel syndrome ,Medicine ,business.industry ,General surgery ,lcsh:R ,digestive, oral, and skin physiology ,lcsh:RJ1-570 ,lcsh:Pediatrics ,medicine.disease ,digestive system diseases ,Intestinal occlusion ,030211 gastroenterology & hepatology ,Differential diagnosis ,business - Abstract
Rapunzel syndrome is a rare form of tricobezoar with a tail extending from the stomach into the small bowel, surgical removal is generally required. About 60 cases have been reported and described in the literature since 1968. We present the case of an 8-year-old girl who, during the course of a genetic consultation, was initially assigned with a clinical suspicion of ectodermal dysplasia. Surgical intervention, which resulted in the extraction of a tricobezoar of enormous size and extension, led us to the diagnosis of Rapunzel syndrome. The possibility of a tricobezoar should be considered in all cases of adolescent patients who present signs of intestinal occlusion or sub-occlusion, suffer from psychiatric disorders, and have a history of trichotillomania. Endoscopic methodology, medical imaging and clinical diagnostics are fundamental for a differential diagnosis. Psychiatric follow-up is advised to prevent recurrence.
- Published
- 2018
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