Trichotillomania, recurrent trichobezoar and Rapunzel syndrome: case report and literature review. 2010

Bulmaro Morales-Fuentes, and Ulises Camacho-Maya, and Fanny Leslie Coll-Clemente, and Juan Carlos Vázquez-Minero
Hospital Rural Oportunidades, Instituto Mexicano del Seguro Social, Motozintla, Chiapas, Mexico. bmfuentes_45@yahoo.com.mx

BACKGROUND Bezoar is a conglomeration of foreign material in the intestinal tract. Trichobezoar (accumulation of hair in the gastric chamber, secondary to impulsive pulling and intake) and Rapunzel syndrome (accumulation of hair in the small intestine) usually occur in children and adolescents with trichotillomania (TTM) and trichophagia history. METHODS We present the case of a 22-year-old female who arrived for consultation. The patient had a 10-month history of intermittent abdominal pain, gastric fullness, nausea, occasional vomiting and weight loss. In addition, she had a history of TTM, trichophagia and previous gastrotomy at 16 years of age. Laboratory tests revealed hypochromic microcytic anemia. Ultrasonographic study demonstrated intense sonic shadowing posterior to the gastric area. After performing gastrotomy, the specimen was extracted and consisted of hair that occupied the entire length of the gastric chamber and part of the small intestine. CONCLUSIONS TTM is characterized by recurrent and impulsive pulling of one's hair for pleasure, gratification, or relief of tension. Children and women <30 years of age are the groups who most frequently suffer from this type of disorder. Hair intake sensation was a cause for presentation of the disease. Data recollection in our environment may provide information for the determination of new information regarding the presence of this condition.

UI MeSH Term Description Entries
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001630 Bezoars Concretions of swallowed hair, fruit or vegetable fibers, or similar substances found in the alimentary canal. Hair Balls,Trichobezoars,Ball, Hair,Balls, Hair,Bezoar,Hair Ball,Trichobezoar
D013577 Syndrome A characteristic symptom complex. Symptom Cluster,Cluster, Symptom,Clusters, Symptom,Symptom Clusters,Syndromes
D014256 Trichotillomania Compulsion to pull out one's hair. Hair Pulling Disorder,Disorder, Hair Pulling,Hair Pulling Disorders,Pulling Disorder, Hair,Trichotillomanias
D055815 Young Adult A person between 19 and 24 years of age. Adult, Young,Adults, Young,Young Adults

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