pica and Syndrome

We report a 14-year-old girl who presented with epigastric pain, vomiting, and an upper abdominal mass. A diagnosis of trichobezoar was made on ultrasound and she went on to have a laparotomy, where a large trichobezoar was extracted with a tail that extended into the small intestine.

Topics: Adolescent; Bezoars; Duodenum; Female; Follow-Up Studies; Humans; Laparotomy; Pica; Risk Assessment; Stomach; Syndrome; Tomography, X-Ray Computed; Treatment Outcome

Topics: Anemia, Iron-Deficiency; Animals; Dwarfism; Egypt; Hepatomegaly; Humans; Hypogonadism; Iran; Male; Pica; Splenomegaly; Syndrome; Zinc

The authors selected among 5 diagnosed cases of larva migrans. In this study, the authors reported a review of this disease.

Topics: Aged; Child, Preschool; Eosinophilia; Humans; Larva Migrans, Visceral; Pica; Syndrome; Thiabendazole

Rapunzel syndrome is a rare case of bowel obstruction resulting from hair ingestion (Trichobezoar). The obstruction can occur in any level of intestinal tract, but usually the stomach is primary involved. This syndrome is usually reported in patients affected by Trichotillomania or Pica syndrome, an obsessive-compulsive disorder that are characterized by an irresistible need to eat body hairs or non-digestible substances 1. When bowel obstruction occurs, it may be treated conservatively, but sometimes surgery is required. We reported two cases of Rapunzel Syndrome in two pediatric patients with different clinical presentation. Both patients were initially treated conservatively but eventually they underwent surgery. KEY WORDS: Bowel obstruction, Rapunzel syndrome, Trichobezoar.. La Sindrome di Raperonzolo è una rara causa di occlusione intestinale correlata alla presenza di un tricobezoar che si localizza a livello gastrico, il quale si estende anche a livello intestinale. I tricobezoar sono corpi estranei che si formano nell’apparato digerente a seguito dell’ingestione di capelli. È una patologia che si riscontra in particolar modo in pazienti affetti da disturbi psichiatrici quali la tricotillomania, disturbo ossessivo compulsivo in cui i pazienti tendono ad ingerire i propri capelli, e il picacismo, disturbo dell’alimentazione in cui i soggetti tendono a ingerire sostanze inorganiche-indigeribili. Il quadro occlusivo dovuto alla presenza di tricobezoar può essere trattato in modo conservativo, ma in casi gravi è necessario l’intervento chirurgico per la rimozione del corpo estraneo. In questo Case Report si discuterà della Sindrome di Raperonzolo e in particolare si discuterà di due casi clinici correlati a tale sindrome. I casi clinici riguardano due giovani pazienti con Sindrome di Raperonzolo, giunte alla nostra osservazione presentando quadri clinici diversi: un quadro di anemia sideropenica da malassorbimento e un quadro franco di occlusione intestinale da tricobezoar. Per gli scarsi risultati del trattamento conservativo, entrambe le pazienti sono state sottoposte ad intervento chirurgico di gastrotomia ed enterotomia in regime d’urgenza per la rimozione dei tricobezoar causanti i diversi quadri clinici.

Topics: Adolescent; Bezoars; Female; Humans; Pica; Stomach; Syndrome; Trichotillomania

Iron 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.. 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.. The 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.

Topics: Abdominal Pain; Adolescent; Anemia, Iron-Deficiency; Bezoars; Diagnosis, Differential; Duodenum; Emergency Service, Hospital; Female; Humans; Pica; Stomach; Syndrome; Tomography, X-Ray Computed; Trichotillomania; Ultrasonography

Topics: Bezoars; Child, Preschool; Diarrhea; Female; Gastroscopy; Humans; Intestinal Obstruction; Intestines; Pica; Stomach; Syndrome; Vomiting

Bezoar is defined as the accumulation of organic or nonbiological substances inside the gastrointestinal system. Trichobezoars are the most frequently detected ones and are mostly present in patients with neuropsychiatric disorders. The continuance of the trichobezoar tail-shaped extension over the duodenum and jejunum is described in Rapunzel syndrome. Both conditions are rarely reported in children. The present case submitted here is related to a 5-year-old girl referred with an abdominal mass and anemia, diagnosed with Rapunzel syndrome and developing trichobezoar due to iron deficiency and pica.

Topics: Anemia, Iron-Deficiency; Bezoars; Child, Preschool; Female; Humans; Jejunum; Pica; Stomach; Syndrome; Treatment Outcome

Topics: Bezoars; Child; Female; Hair; Humans; Microscopy, Electron, Scanning; Pica; Prognosis; Stomach; Stress, Psychological; Syndrome; Trichotillomania

Topics: Equipment Design; Foreign Bodies; Gastroscopes; Gastroscopy; Humans; Middle Aged; Pica; Radiography, Abdominal; Schizophrenia, Paranoid; Syndrome

Topics: Adult; Atrophy; Brain Diseases; Fatal Outcome; Frontal Lobe; Humans; Hyperphagia; Male; Middle Aged; Pica; Psychomotor Agitation; Status Epilepticus; Syndrome

The authors report five, mortal, vasculo-cerebral hemorrhage complications in anaemic and geographic patients. The five observations are stereotyped, the accidents occurring two weeks after the start of treatment, which included a complete blood transfusion and the admission of injectable iron and oral folic acid. Physiopathogenesis is obscure, and no identical case seems to be described in literature. The authors link these accidents to less serious neurological manifestations normally observed during iron-deficient anaemia. They blame cerebral anoxia and the deficient terrain.

Topics: Adolescent; Anemia, Hypochromic; Anemia, Macrocytic; Blood Transfusion; Brain Ischemia; Cerebral Hemorrhage; Child; Female; Folic Acid; Folic Acid Deficiency; Humans; Iron; Iron Deficiencies; Male; Nutrition Disorders; Pica; Pseudotumor Cerebri; Retrospective Studies; Senegal; Syndrome

Topics: Anemia, Hypochromic; Child, Preschool; Female; Humans; Iron; Male; Pica; Syndrome

Oral iron and zinc tolerance tests were performed in 12 patients between 8 and 21 years of age, with iron deficiency anemia and geophagia. Decreased iron and zinc absorption were detected respectively in patients against the elevated absorption curves in control subjects. Iron and zinc malabsorption may be an additional feature of the syndrome characterized by geophagia, iron deficiency anemia, hepatosplenomegaly, hypogonadism and dwarfism observed in Turkey and Iran.

Topics: Adolescent; Adult; Anemia, Hypochromic; Child; Duodenum; Female; Hepatomegaly; Humans; Hypogonadism; Intestinal Absorption; Iron; Male; Pica; Radiography; Skull; Splenomegaly; Syndrome; Turkey; Zinc

The syndrome of dwarfism, hypogonadism, iron-deficiency anemia and geophagia, first reported in 1960 from Iran, was thought to be limited to males. In 1971-1972 two females with the same clinical features were observed over a 14-month period. The anemia responded rapidly to iron. Growth and sexual development occurred promptly when 120 mg of zinc sulfate was administered daily in conjunction with a well-balanced diet and iron supplement. This diet prior to the addition of zinc sulfate, resulted in gradual but much slower growth and sexual development. Observations in these two patients provide confirmation of the occurrence of human zinc deficiency in females, which responds to large doses of zinc salt.

Topics: Adult; Anemia, Hypochromic; Deficiency Diseases; Dwarfism; Female; Humans; Hypogonadism; Iran; Nutritional Physiological Phenomena; Pica; Sex Factors; Soil; Syndrome; Zinc

Topics: Central Nervous System; Chelating Agents; Child, Preschool; Female; Humans; Hyperkinesis; Infant; Lead; Lead Poisoning; Male; Motor Activity; Penicillamine; Pica; Sex Factors; Syndrome