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Case Reports
. 2023 Apr 23;15(4):e38016.
doi: 10.7759/cureus.38016. eCollection 2023 Apr.

A Triad of Trichobezoar: Rapunzel Syndrome, Severe Malnutrition, and Cerebral Venous Thrombosis

Affiliations
Case Reports

A Triad of Trichobezoar: Rapunzel Syndrome, Severe Malnutrition, and Cerebral Venous Thrombosis (VSports最新版本)

Minal Shastri et al. Cureus. .

Abstract

Trichobezoar is a rare condition almost exclusively seen in young females presenting with non-specific abdominal complaints and a history of psychiatric illness VSports手机版. In most patients, it is confined within the stomach; however, in some severe cases, it extends through the pylorus into the duodenum, jejunum, ileum, or even colon, known as Rapunzel syndrome. Conventional treatment includes laparotomy and psychiatric counseling to prevent relapses. We report the case of an 18-year-old female with no previous history of medical or psychiatric illness who presented with chief complaints of upper abdominal pain, nausea, occasional vomiting for the last six months, and generalized edema for the last three days. On examination, pallor, anasarca, and a palpable abdominal lump were present. On blood investigations, severe malnutrition was seen in the form of severe iron deficiency anemia and severe protein deficiency. Radiological evaluation revealed a large trichobezoar on the CT abdomen and endoscopy, whereas CT venography of the brain, done for persistent headache, showed hyperdense thrombi in the cortical veins. Exploratory laparotomy was done to remove trichobezoar, followed by medical management of malnutrition, cerebral venous thrombosis (CVT) with anticoagulants, and psychiatric counseling for trichobezoar. The association between trichobezoar, malnutrition, and CVT in our case is a further area of research. .

Keywords: cerebral venous thrombosis; malnutrition; rapunzel syndrome; trichobezoar; trichotillomania. V体育安卓版.

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Conflict of interest statement

The authors have declared that no competing interests exist.

VSports手机版 - Figures

Figure 1
Figure 1. Axial section of CT abdomen and pelvis showing trichobezoar
CT, computed tomography
Figure 2
Figure 2. Axial section of CECT abdomen and pelvis showing trichobezoar
CECT, contrast-enhanced computed tomography
Figure 3
Figure 3. Coronal section of CECT abdomen and pelvis showing trichobezoar
CECT, contrast-enhanced computed tomography
Figure 4
Figure 4. Sagittal section of CECT abdomen and pelvis showing trichobezoar
CECT, contrast-enhanced computed tomography
Figure 5
Figure 5. Endoscopy showing a normal esophagus
Figure 6
Figure 6. Endoscopy showing trichobezoar in the stomach
Figure 7
Figure 7. Endoscopy showing trichobezoar extending through the pyloric channel
Figure 8
Figure 8. CT venography showing straight sinus and lateral sinuses
CT, computed tomography
Figure 9
Figure 9. Axial section of CT venography showing thrombus of the straight sinus
CT, computed tomography
Figure 10
Figure 10. A large trichobezoar extending from the stomach to the proximal jejunum removed by exploratory laparotomy

References (VSports最新版本)

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