pica and Edema

Rapunzel syndrome is a rare form of gastric trichobezoar. A 4-year-old girl presented with generalised oedema and an epigastric mass. Her family was of a relatively low socio-economic background. There was microcytic hypochromic anaemia, hypoalbuminaemia and an elevated α1-antitrypsin clearance. Abdominal ultrasound and non-contrast computed tomography demonstrated a heterogeneous mass related to the stomach. Upper gastro-intestinal tract endoscopy failed to remove it. Surgical laparotomy was undertaken through a single anterior gastrotomy incision and a large mass was extracted which was a cast of the duodenum and stomach and had a tail of approximately 60 cm in length which extended to the jejunum. Low socio-economic status, child neglect and pica are risk factors for trichobezoars. Surgical laparotomy is the optimal treatment of large bezoars.

Topics: Bezoars; Child, Preschool; Edema; Endoscopy, Gastrointestinal; Female; Humans; Infant; Laparotomy; Male; Pica; Radiography, Abdominal; Risk Factors; Socioeconomic Factors; Stomach Diseases; Tomography, X-Ray Computed; Ultrasonography

Topics: Body Weight; Deficiency Diseases; Diet, Diabetic; Diet, Reducing; Edema; Female; Fetus; Folic Acid Deficiency; Humans; Infant Mortality; Infant, Newborn; Nutritional Physiological Phenomena; Obesity; Physician-Patient Relations; Pica; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy in Diabetics

Collagenous gastritis is an uncommon gastrointestinal disease in children. Its cause remains uncertain. It may present as severe hypoproteinaemia manifesting as generalized oedema. We report a 15 months old female who presented with pica, generalized body oedema and diarrhoea. Diagnostic workup revealed gastric replacement of the lamina propria by hyalinized collagen on histology. This case seeks to highlight the need for early paediatric gastroenterology referral including oesophagogastroduodenoscopy with multiple tissue biopsies as part of a broad diagnostic workup in children with non-specific gastrointestinal symptoms to improve diagnostic yield and enable accurate histologic diagnosis, so that appropriate therapy can be timeously applied.

Topics: Albumins; Anemia, Iron-Deficiency; Azathioprine; Biopsy; Collagen; Diarrhea; Edema; Endoscopy, Gastrointestinal; Female; Gastric Mucosa; Gastritis; Humans; Hypoalbuminemia; Hypoproteinemia; Infant; Pica; Prednisone; Treatment Outcome; Water-Electrolyte Balance

Topics: Anemia; Blood Transfusion; Edema; Ferric Compounds; Ferric Oxide, Saccharated; Ferrous Compounds; Foot; Glucaric Acid; Hematinics; Humans; Infant; Male; Oxygen Inhalation Therapy; Pica

Topics: Cheek; Chelation Therapy; Child, Preschool; Dimercaprol; Drug Therapy, Combination; Edema; Edetic Acid; Environmental Exposure; Foreign Bodies; Humans; Lead; Lead Poisoning; Male; Pica; Play and Playthings; Protoporphyrins; Seizures; Self-Injurious Behavior; Succimer; Wounds, Gunshot

Topics: Adolescent; Adult; Age Factors; Anemia, Hypochromic; Blood Proteins; Body Height; Body Weight; Edema; Female; Growth Disorders; Helminthiasis; Hemoglobinometry; Hepatomegaly; Humans; Infections; Iran; Male; Nutrition Disorders; Pica; Protein Deficiency; School Health Services; Serum Albumin; Serum Globulins; Soil; Splenomegaly; Zinc