Trichobezoar masquerading as massive splenomegaly: Rapunzel's syndrome revisited
Trichobezoars are usually formed due to ingestion of hair or hair-like fibres and present with a wide spectrum of clinical manifestations. We report a case of Rapunzel's syndrome associated with trichotillomania in a 16-year-old girl who presented to our Haematology unit with complaints of fati...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | Radiology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S193004332200276X |
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| author | Alex Zhi Yang Koh, MD Larry Ellee Nyanti, MBBChBAO, MRCPI Sheri Lim, MBBChBAO Tien Loong Luk, FRCS Andy Sing Ong Tang, MD, MRCP Tze Shin Leong, MBBS, MRCP Lee Ping Chew, MD, MRCP |
| author_facet | Alex Zhi Yang Koh, MD Larry Ellee Nyanti, MBBChBAO, MRCPI Sheri Lim, MBBChBAO Tien Loong Luk, FRCS Andy Sing Ong Tang, MD, MRCP Tze Shin Leong, MBBS, MRCP Lee Ping Chew, MD, MRCP |
| author_sort | Alex Zhi Yang Koh, MD |
| collection | DOAJ |
| description | Trichobezoars are usually formed due to ingestion of hair or hair-like fibres and present with a wide spectrum of clinical manifestations. We report a case of Rapunzel's syndrome associated with trichotillomania in a 16-year-old girl who presented to our Haematology unit with complaints of fatigue, abdominal distention, and early satiety. Initial evaluation demonstrated anaemia, thrombocytosis, and a left hypochondrial mass suggestive of splenomegaly. However, ultrasound of the abdomen showed no hepatosplenomegaly and blood investigations were not suggestive of haematological malignancy. Not long after, the patient presented to the emergency department with suspected acute abdomen. Computed tomography of the abdomen revealed intraluminal gastric and jejunal masses causing small bowel obstruction. Emergency laparotomy confirmed gastric and jejunal trichobezoars, and subsequent psychiatric evaluation confirmed trichotillomania. Clinicians should consider trichobezoar in the differential diagnosis of abdominal pain and a non-tender ‘spleen-like’ abdominal mass. |
| first_indexed | 2024-04-14T00:46:23Z |
| format | Article |
| id | doaj.art-b2c89567c5f249c192b4c0847ce3cf5f |
| institution | Directory Open Access Journal |
| issn | 1930-0433 |
| language | English |
| last_indexed | 2024-04-14T00:46:23Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj.art-b2c89567c5f249c192b4c0847ce3cf5f2022-12-22T02:22:00ZengElsevierRadiology Case Reports1930-04332022-06-0117622432246Trichobezoar masquerading as massive splenomegaly: Rapunzel's syndrome revisitedAlex Zhi Yang Koh, MD0Larry Ellee Nyanti, MBBChBAO, MRCPI1Sheri Lim, MBBChBAO2Tien Loong Luk, FRCS3Andy Sing Ong Tang, MD, MRCP4Tze Shin Leong, MBBS, MRCP5Lee Ping Chew, MD, MRCP6Haematology Unit, Department of Internal Medicine, Sarawak General Hospital, Ministry of Health, Sarawak, MalaysiaHaematology Unit, Department of Internal Medicine, Sarawak General Hospital, Ministry of Health, Sarawak, Malaysia; Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia; Corresponding author.Accident and Emergency Unit, Borneo Medical Centre, Ministry of Health, Sarawak, MalaysiaDepartment of Surgery, Borneo Medical Centre, Ministry of Health, Sarawak, MalaysiaHaematology Unit, Department of Internal Medicine, Sarawak General Hospital, Ministry of Health, Sarawak, MalaysiaHaematology Unit, Department of Internal Medicine, Sarawak General Hospital, Ministry of Health, Sarawak, MalaysiaHaematology Unit, Department of Internal Medicine, Sarawak General Hospital, Ministry of Health, Sarawak, MalaysiaTrichobezoars are usually formed due to ingestion of hair or hair-like fibres and present with a wide spectrum of clinical manifestations. We report a case of Rapunzel's syndrome associated with trichotillomania in a 16-year-old girl who presented to our Haematology unit with complaints of fatigue, abdominal distention, and early satiety. Initial evaluation demonstrated anaemia, thrombocytosis, and a left hypochondrial mass suggestive of splenomegaly. However, ultrasound of the abdomen showed no hepatosplenomegaly and blood investigations were not suggestive of haematological malignancy. Not long after, the patient presented to the emergency department with suspected acute abdomen. Computed tomography of the abdomen revealed intraluminal gastric and jejunal masses causing small bowel obstruction. Emergency laparotomy confirmed gastric and jejunal trichobezoars, and subsequent psychiatric evaluation confirmed trichotillomania. Clinicians should consider trichobezoar in the differential diagnosis of abdominal pain and a non-tender ‘spleen-like’ abdominal mass.http://www.sciencedirect.com/science/article/pii/S193004332200276XTrichobezoarSplenomegalyTrichotillomaniaRapunzel's syndromeAnaemia |
| spellingShingle | Alex Zhi Yang Koh, MD Larry Ellee Nyanti, MBBChBAO, MRCPI Sheri Lim, MBBChBAO Tien Loong Luk, FRCS Andy Sing Ong Tang, MD, MRCP Tze Shin Leong, MBBS, MRCP Lee Ping Chew, MD, MRCP Trichobezoar masquerading as massive splenomegaly: Rapunzel's syndrome revisited Radiology Case Reports Trichobezoar Splenomegaly Trichotillomania Rapunzel's syndrome Anaemia |
| title | Trichobezoar masquerading as massive splenomegaly: Rapunzel's syndrome revisited |
| title_full | Trichobezoar masquerading as massive splenomegaly: Rapunzel's syndrome revisited |
| title_fullStr | Trichobezoar masquerading as massive splenomegaly: Rapunzel's syndrome revisited |
| title_full_unstemmed | Trichobezoar masquerading as massive splenomegaly: Rapunzel's syndrome revisited |
| title_short | Trichobezoar masquerading as massive splenomegaly: Rapunzel's syndrome revisited |
| title_sort | trichobezoar masquerading as massive splenomegaly rapunzel s syndrome revisited |
| topic | Trichobezoar Splenomegaly Trichotillomania Rapunzel's syndrome Anaemia |
| url | http://www.sciencedirect.com/science/article/pii/S193004332200276X |
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