The cause of abdominal mass in a child with celiac disease: Rapunzel syndrome. A case report

ABSTRACT CONTEXT: Rapunzel syndrome is a rare form of gastric trichobezoar that develops through outstretching of the bezoar from the stomach to the intestine. CASE REPORT: A 12-year-old girl who had been diagnosed with celiac disease six years earlier was brought to the department of pediatric gastroenterology because of abdominal distension. A palpable mass was detected. A trichobezoar that stretched to the small intestine was removed surgically. The patient was diagnosed as having anxiety and depressive disorder, and treatment started. Following the treatment, her previous trichophagia completely disappeared. CONCLUSION: Presence of trichobezoar should be kept in mind, especially when young girls who have psychiatric problems suffer from gastrointestinal symptoms.摘要背景：拉普齐尔综合征（Rapunzel syndrome）是一种罕见的胃毛粪石（gastric trichobezoar）亚型，其发病机制为毛粪石从胃延伸至肠道。病例报告：一名六年前确诊乳糜泻的12岁女孩因腹胀前往儿科胃肠病科就诊。查体可触及腹部肿块，手术切除了一条延伸至小肠的毛粪石。患者同时被诊断为焦虑与抑郁障碍，随即启动相应治疗。经治疗后，其食毛癖（trichophagia）症状完全消失。结论：临床工作中应警惕毛粪石的发生，尤其是当存在精神疾病的年轻女性出现胃肠道症状时。