An atypical death from Rapunzel syndrome: a case report.

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  • Additional Information
    • Source:
      Publisher: Humana Press Country of Publication: United States NLM ID: 101236111 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1556-2891 (Electronic) Linking ISSN: 1547769X NLM ISO Abbreviation: Forensic Sci Med Pathol Subsets: MEDLINE
    • Publication Information:
      Original Publication: Totowa, N.J. : Humana Press, c2005-
    • Subject Terms:
      Bezoars*/diagnosis ; Bezoars*/etiology ; Bezoars*/psychology ; Trichotillomania*/complications ; Trichotillomania*/diagnosis; Female ; Child ; Humans ; Child, Preschool ; Stomach ; Intestine, Small ; Hair ; Syndrome
    • Abstract:
      Trichotillomania is a psychiatric disorder characterized by recurring urges to pulling out hairs, eyelashes, or down in other parts of the body. Trichophagia, which is the urge to ingesting the pulled-out hairs, can cause Rapunzel syndrome, an unusual disorder where gastric trichobezoars can be found in the small intestine. Trichobezoars, amorphous masses composed of undigested food formed by hairs, can obstruct the gastrointestinal tract up to simulating symptoms typical of bowel obstruction. Rapunzel syndrome, named after Grimm's tale, may cause death, especially in the pediatric population, being it seldom over the age of 6; moreover, developing countries and environmental and familiar issues are listed as uncertain risk factors. The present case report deals with the death of a 4-year-old female occurred after lunch and following a series of vomit events; while no traumatic or pathological findings were revealed at the external examination, the autopsy revealed three large trichobezoars localized in the stomach and the small intestine. Despite death was due to gastrointestinal obstruction for multiple trichobezoars and collateral bronchoaspiration of dietary material, histological findings were totally non-specific, meaning that it is sometimes difficult to conclude that death is related to the primary pathological condition.
      (© 2023. The Author(s).)
    • References:
      World J Gastroenterol. 2005 Mar 28;11(12):1813-7. (PMID: 15793871)
      Dig Surg. 2007;24(3):157-61. (PMID: 17476105)
      Mov Disord. 2012 Apr;27(4):588-90. (PMID: 22287105)
      Afr J Paediatr Surg. 2022 Apr-Jun;19(2):102-104. (PMID: 35017380)
      J Forensic Sci. 2015 Mar;60(2):341-5. (PMID: 25537433)
      World J Clin Cases. 2017 Feb 16;5(2):50-55. (PMID: 28255548)
      Front Pediatr. 2021 Jun 09;9:684379. (PMID: 34178901)
      Psychopharmacol Bull. 1998;34(2):221-4. (PMID: 9641004)
      Pediatr Gastroenterol Hepatol Nutr. 2013 Jun;16(2):127-30. (PMID: 24010117)
      Med J Aust. 1986 Dec 1-15;145(11-12):613-4. (PMID: 3540541)
      J Pediatr Surg. 2005 Oct;40(10):1665-7. (PMID: 16227005)
      Am J Gastroenterol. 1982 Jul;77(7):467-70. (PMID: 7091135)
      J Pediatr Surg. 2020 Nov;55(11):2504-2509. (PMID: 32467033)
      Forensic Sci Int. 2009 Sep 10;190(1-3):e5-7. (PMID: 19505779)
      World J Surg. 2007 May;31(5):1072-8; discussion 1079-80. (PMID: 17420961)
      East Afr Med J. 2001 Nov;78(11):619-20. (PMID: 12219971)
    • Contributed Indexing:
      Keywords: Autopsy; Forensic pathology; Rapunzel syndrome; Trichobezoars; Trichophagia
    • Publication Date:
      Date Created: 20230209 Date Completed: 20230710 Latest Revision: 20240216
    • Publication Date:
      20240216
    • Accession Number:
      PMC10328900
    • Accession Number:
      10.1007/s12024-023-00588-4
    • Accession Number:
      36757661