Trichobezoar (Rapunzel Syndrome) Causing Severe Anaemia and Cardiac Failure

Introduction

Bezoars are an accumulation of indigestible materials in the gastrointestinal tract (GIT) and they are classified according to their content. The word “Bezoar” is derived from the Arabic word “badzehr”, which means “antidote” and the first case was described in 1779 by Baudamant (Grant JE, et al., Compr Psychiatry 2008; 49:579–584). The most frequent bezoars are phytobezoar (fibers or plants), lactobezoar (milk), pharmacobezoar (medication) and trichobezoar (hair bundles) and the most frequent location is the stomach followed by the upper GIT. They are more prevalent in young females and associated with psychiatric disorders or mental retardation. If the bezoar prolapses into the small intestine it is also called Rapunzel syndrome referring to the Grimm brothers’ tale (Kim SC et al., Medicine (Baltimore) 2016; 95: 3745). In the present paper we report, an 8-year-old Romanian girl with gastric trichobezoar and “Pica” disorder causing severe iron-deficiency anaemia and acute cardiac failure.