Pediatric Gastroenterology, Hepatology & Nutrition  2013;16(2):127-130

doi:10.5223/pghn.2013.16.2.127

A Case of Rapunzel Syndrome.

Joon Sung KIM 1 ; Chang Woo NAM

Affiliations

+expand

Keywords

Rapunzel syndrome; Bezoars; Trichotillomania; Trichophagia; Abdominal pain

Country

Republic of Korea

Language

English

Abstract

Rapunzel syndrome refers to a very rare condition in which swallowed hair forms a gastric trichobezoar that has a long tail extending into the small bowel. We describe a case of Rapunzel syndrome in an 8-year-old girl who presented with abdominal mass, epigastric pain and vomiting. Abdominal computed tomography scan showed a markedly dilated stomach filled with coarse heterogeneous materials. Upper gastrointestinal endoscopy revealed a huge hairy ball with a tail extending through the pylorus. We performed a surgical laparotomy and successfully removed a huge trichobezoar with a long tail extending into the middle portion of jejunum. Psychiatric consultation with review showed her past history of trichotillomania and trichophagia 4 years ago. But her parents denied further psychiatric therapy and she was lost to the follow-up. Rapunzel syndrome should be included in the differential diagnosis in children with chronic abdominal pain and trichophagia.