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CASE REPORT
Year : 2014  |  Volume : 15  |  Issue : 2  |  Page : 258-260

A rare case of paediatric trichotillomania complicating into Rapunzel syndrome: a case report


1 Consultant Psychiatrist, Maithri psychiatry centre, Hyderabad, India
2 Consultant Dermatologist, Krishna children's Hospital, Hyderabad, India
3 Consultant Paediatrician, Krishna children's Hospital, Hyderabad, India
4 Consultant Paediatric surgeon, Krishna children's Hospital, Hyderabad, India

Correspondence Address:
Preethi Swaroop Bollapalli
Address: 137/B, MIGH, S.R. Nagar, Hyderabad 500038, Telangana
India
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Source of Support: None, Conflict of Interest: None


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Background: Trichotillomania is a psychological condition that involves strong urge to pull one's hair. Trichophagia is disorder of eating of hair. Bezoar is collection of undigested material such as hair, drugs and plastic or combinations. Rapunzel syndrome is a rare type of trichobezoar, which has mass of hair lodged in stomach extending up to ileum. In majority, diagnosis is made very late, at a stage where surgery is the only option. Case description: A 9 year old girl was brought with complaints of loss of hair on scalp since 8 months, decreased appetite, and constipation, weight loss since 5 months and vomiting since 2 weeks. Patient had paediatric consultations without much benefit; patient was referred to dermatologist and paediatric surgeon. Ultrasound showed mass in abdomen. Patient was operated to find a mass extending from stomach to terminal ileum. Patient was referred to a Psychiatrist and diagnosis of Trichotillomania was made. Discussion: Trichobezoar is common in young females, often with an underlying psychiatric disorder, they present late due to the low index of suspicion. As this condition is a rarity in paediatric age group and very little progress to Rapunzel syndrome, this paper discusses about the systemic team management of the above individual. Conclusion: High index of suspicion is needed to diagnose this condition in paediatric age group.


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