CME Article

Adolescent Abdominal Pain with a Twist

Meera S. Beharry, MD, FAAP

  • Pediatric Annals
  • June 2012 - Volume 41 · Issue 6: 13-15
  • DOI: 10.3928/00904481-20120525-11
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Abstract

CME Educational Objectives

  1. Delineate the DSM-IV criteria for trichotillomania.

  2. Identify the clinical findings in patients with trichotillomania.

  3. Describe the presenting symptoms found in patients with a trichobezoar and outline the complications associated with this disorder.

A 17-year-old young woman presented to her pediatrician for evaluation of abdominal pain and increased eructation (belching). She described the pain as a burning or boring sensation that became worse with eating. Review of her dietary history revealed no clear cause of the pain. The patient reported normal bowel movements occurring every day or every other day. She denied the presence of blood or mucous in her stool. Past medical history was positive for a history of alopecia that was first noted 3 years ago. Work-up for a cause of the alopecia was negative, and the alopecia was determined to be related to stress. Menstrual history included menarche at age 12 years, with normal menses occurring every month and lasting 5 days. Family history was negative for gastrointestinal disorders, such as inflammatory bowel disease and irritable bowel syndrome, and for autoimmune disorders, such as systemic lupus erythematosus. The patient’s physical examination showed an anxious, thin young woman who was in no apparent distress. Oropharynx was normal and without lesions, bowel sounds were normo-active, and abdominal examination revealed a scaphoid abdomen without organomegaly or palpable masses.

AUTHORS

Meera S. Beharry, MD, FAAP, is Assistant Professor of Pediatrics and Adolescent Medicine, Division of Adolescent Medicine, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY.

Disclosure: Dr. Beharry has disclosed no relevant financial relationships.

Address correspondence to: Meera S. Beharry, MD, FAAP, Department of Pediatrics, University of Rochester Medical Center, 601 Elmwood Avenue, Box 690, Rochester, NY 14642; fax: 585-242-9733; email: meera_beharry@urmc.rochester.edu

doi: 10.3928/00904481-20120525-11

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