RAPUNZEL SYNDROME
Abstract
A trichobezoar may be confined to the stomach or unusually it may extend from stomach to thesmall intestine or beyond when it is labelled as Rapunzel syndrome. Bezoars are concretions in thegastrointestinal tract that increase in size by continuous accumulation of non-absorbable food orfibre. Most bezoars in children are trichobezoars from swallowed hair. Repunzal syndrome is anuncommon condition in children with less than 40 cases reported. We present a case of an 8 year oldgirl with Rapunzel syndrome. She presented with vague abdominal pain and epigastric fullness ofone year duration. On investigation she was found to have a trichobezoar. At laparotomy a largedark foul smelling trichobezoar that occupied the stomach, duodenum and proximal jejunum wasremoved via gastrostomy.Keywords: Trichobezoar, abdominal mass, Rapunzel syndromeReferences
Phillips MB, Zaheer S, Drugas GT. Gastric trichobezoar,
case report and literature review. Mayo Clin Pros
;73:653–6.
Vaughan ED, Saweyers JI, Scott HW Jr. The Rapunzel
syndrome: An unusual complication of intestinal bezoar.
Surgery 1968;63:339–43.
Naik S, Gupta V, Naik S, Rangole A, Chaudhary AK, Jain P,
Sharma AK. Rapunzel Syndrome reviewed and redefined.
Dig Surg 2007;24:157–61.
Bouwer C, Stein DJ. Trichobezoars in Trichotillomania:case
report and literature review. Psychosom Med 1998;60:658–
Kaspar A, Deeg KH, Schmidt K, Meister R. [Rapunzel
Syndrome, a rare form of intestinal trichobezoars] Klin
Padiatr 1999;211:420–2.
Pace AP, Fearne C. Trichobezoar in a 13 year old male: a
case report and review of literature. Malta Med J
;15:39–40.
Mc Gehee FT, Buchanan GR. Trichophagia and trichobezoar.
Etiologic role of iron deficiency. J Pediatr 1990;97:946–8.
Shawig RN, Doig CM. Gastric trichobezoar associated with
transient pancreatitis. Arch Dis Child 1984;59:994.
Kowshik NK, Sharma YP, Negi A, Jaswal A. Images–gastric
trichobezoar. Indian J Radiol, Imaging 1999;9:137–9.
Memon AS, Mandhan P, Qureshi JN, Shairani AJ. Recurrent
Rupenzel syndrome-a case report. Med Sci Monit
;9(9):CS92–4.
