Acute Abdominal Pain with Obstructing Trichobezoar: A Pediatric Case of Rapunzel Syndrome Diagnosed in a Pediatric Emergency Department

Introduction: Acute abdominal pain is a prevalent complaint in pediatric emergency departments. Primary care physicians can find it challenging to treat such pain and, in particular, to determine whether it requires emergent surgical intervention. Acute appendicitis is the most common surgical cause...

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Main Authors: Sung-Ha Kim, Jong-In Lee, Soohyun Park, So-Hyun Paek
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Pediatric Reports
Subjects:
Online Access:https://www.mdpi.com/2036-7503/17/3/53
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author Sung-Ha Kim
Jong-In Lee
Soohyun Park
So-Hyun Paek
author_facet Sung-Ha Kim
Jong-In Lee
Soohyun Park
So-Hyun Paek
author_sort Sung-Ha Kim
collection DOAJ
description Introduction: Acute abdominal pain is a prevalent complaint in pediatric emergency departments. Primary care physicians can find it challenging to treat such pain and, in particular, to determine whether it requires emergent surgical intervention. Acute appendicitis is the most common surgical cause of abdominal pain, but it is important to understand that other rare conditions can also be life-threatening. Case presentation: We report the case of a 6-year-old girl who presented to our pediatric emergency center with complaints of acute abdominal pain, vomiting, and diarrhea. She had no notable medical history, including perinatal, surgical, or psychiatric disorders. After finding a bezoar-like structure through a combined enteritis CT scan, reassessing the child’s dietary concerns revealed that the child had experienced symptoms of trichophagia for approximately 3 to 4 years. Enterotomy and the removal of the bezoar were successfully performed. A pediatric psychiatric consultation was carried out to prevent further trichophagia-induced complications. Conclusions: Despite our patient’s relatively young age and the failure to obtain a history of trichophagia at the onset, we successfully diagnosed a rare condition called Rapunzel syndrome. Although several cases of this condition have been reported by pediatric surgeons, we emphasize the role of physicians in pediatric emergency departments when examining children with this rare syndrome.
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spelling doaj-art-0f353052d3f54c8c9c1abbe2dec89f982025-08-20T03:29:35ZengMDPI AGPediatric Reports2036-75032025-04-011735310.3390/pediatric17030053Acute Abdominal Pain with Obstructing Trichobezoar: A Pediatric Case of Rapunzel Syndrome Diagnosed in a Pediatric Emergency DepartmentSung-Ha Kim0Jong-In Lee1Soohyun Park2So-Hyun Paek3Department of Emergency Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13497, Republic of KoreaDepartment of Pediatric Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13497, Republic of KoreaDepartment of Emergency Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13497, Republic of KoreaDepartment of Emergency Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13497, Republic of KoreaIntroduction: Acute abdominal pain is a prevalent complaint in pediatric emergency departments. Primary care physicians can find it challenging to treat such pain and, in particular, to determine whether it requires emergent surgical intervention. Acute appendicitis is the most common surgical cause of abdominal pain, but it is important to understand that other rare conditions can also be life-threatening. Case presentation: We report the case of a 6-year-old girl who presented to our pediatric emergency center with complaints of acute abdominal pain, vomiting, and diarrhea. She had no notable medical history, including perinatal, surgical, or psychiatric disorders. After finding a bezoar-like structure through a combined enteritis CT scan, reassessing the child’s dietary concerns revealed that the child had experienced symptoms of trichophagia for approximately 3 to 4 years. Enterotomy and the removal of the bezoar were successfully performed. A pediatric psychiatric consultation was carried out to prevent further trichophagia-induced complications. Conclusions: Despite our patient’s relatively young age and the failure to obtain a history of trichophagia at the onset, we successfully diagnosed a rare condition called Rapunzel syndrome. Although several cases of this condition have been reported by pediatric surgeons, we emphasize the role of physicians in pediatric emergency departments when examining children with this rare syndrome.https://www.mdpi.com/2036-7503/17/3/53abdominal painRapunzel syndromesmall bowel obstructiontrichophagiatrichobezoar
spellingShingle Sung-Ha Kim
Jong-In Lee
Soohyun Park
So-Hyun Paek
Acute Abdominal Pain with Obstructing Trichobezoar: A Pediatric Case of Rapunzel Syndrome Diagnosed in a Pediatric Emergency Department
Pediatric Reports
abdominal pain
Rapunzel syndrome
small bowel obstruction
trichophagia
trichobezoar
title Acute Abdominal Pain with Obstructing Trichobezoar: A Pediatric Case of Rapunzel Syndrome Diagnosed in a Pediatric Emergency Department
title_full Acute Abdominal Pain with Obstructing Trichobezoar: A Pediatric Case of Rapunzel Syndrome Diagnosed in a Pediatric Emergency Department
title_fullStr Acute Abdominal Pain with Obstructing Trichobezoar: A Pediatric Case of Rapunzel Syndrome Diagnosed in a Pediatric Emergency Department
title_full_unstemmed Acute Abdominal Pain with Obstructing Trichobezoar: A Pediatric Case of Rapunzel Syndrome Diagnosed in a Pediatric Emergency Department
title_short Acute Abdominal Pain with Obstructing Trichobezoar: A Pediatric Case of Rapunzel Syndrome Diagnosed in a Pediatric Emergency Department
title_sort acute abdominal pain with obstructing trichobezoar a pediatric case of rapunzel syndrome diagnosed in a pediatric emergency department
topic abdominal pain
Rapunzel syndrome
small bowel obstruction
trichophagia
trichobezoar
url https://www.mdpi.com/2036-7503/17/3/53
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AT soohyunpark acuteabdominalpainwithobstructingtrichobezoarapediatriccaseofrapunzelsyndromediagnosedinapediatricemergencydepartment
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