DOI: http://dx.doi.org/10.18203/2349-2902.isj20184661

Rapunzel syndrome: a review of unusual case

Foram Arvindbhai Modh

Abstract


A rare condition characterized by trichophagia, or the swallowing of one’s own own hair, leading to a solid mass that forms in the gastrointestinal tract. The resulting blockage of the gastrointestinal tract may be fatal. The hair forms a solid mass in the digestive tract known as a trichobezoar. It causes abdominal pain and nausea, but can also present as an asymptomatic abdominal mass, progressing to abdominal obstruction and perforation. It is predominantly found in emotionally disturbed or mentally retarded youngsters. We present the youngest case of Rapunzel syndrome in the Surat Municipal Institute of Medical Education and Research Hospital, Surat, India, a 7-year-old girl who present with abdominal pain and non-tender abdominal mass.


Keywords


Abdominal mass, Trichophagia, Trichobezoar, Rapunzel syndrome

Full Text:

PDF

References


Dart RC. Medical toxicology. 3rd edition, Philadelphia: Lippincott, Williams and Wilkins; 2004:1301.

Wang C, Zhao X, Mao S, Wang Y, Cui X. Management of SAH with traditional Chinese medicine in China. Neurol Res. 2006;28:436-44.

Vaughan ED, Sawyers JL, Scott HW. The Rapunzel syndrome. An unusual complication of intestinal bezoar. Surgery. 1968;63:339-43.

Ousadden A, Mazaz K, Mellouki I, Taleb KA. Gastric trichobezoar: one case report. Ann Chir. Philadelphia: Lippincott, Williams and Wilkins, 2004;129: 237-40.

Grimm Brothers: Rapunzel. Translated by Godwin-Jones R. Richmond, Virginia Commonwealth University Department of Foreign Languages, 1994-1999.

Naik S, Gupta V, Naik S, Rangole A, Chaudhary AK, Jain P. Rapunzel syndrome reviewed and redefined. Dig Surg. 2007;24:157-61.

Singh G, Mitra SK. Gastric perforation secondary to recurrent trichobezoar. Indian J Pediatr. 1996;63(5):689-91.

Goldstein SS, Lewis JH, Rothstein R. Intestinal obstruction due to bezoars. Am J Gastroenterol. 1984;79:313-8.

Jiledar Singh G, Mitra SK. Gastric perforation secondary to recurrent trichobezoar. Indian J Pediatr. 1996;63:689-91.

Klipfel AA, Kessler E, Schein M. Rapunzel syndrome causing gastric emphysema and small bowel obstruction. Surg. 2003;133:120-1.

Wang YG, Seitz U, Li ZL, Soehendra N, Qiao XA. Endoscopic management of huge bezoars. Endoscopy. 1998;30:371-4.

Ferenci P, Lockwood AH, Mullen KD, Tarter RE, Weissenborn K, Blei AT. Hepatic encephalopathy: definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congress of Gastroenterol, Vienna. Hepatol. 2002;35:716-21.

Walker-Renard P. Update on the medicinal management of phytobezoars. Am J Gastroenterol. 1993;88:1663-6.

Gockel I, Gaedertz C, Hain HJ, Winckelmann U, Albani MI, Lorenz D. The Rapunzel syndrome: rare manifestation of a trichobezoar of the upper gastrointestinal tract. Chinurg. 2003;74:753-6.

Sharma NL, Sharma RC, Mahajan VK, Sharma RC, Chauhan D, Sharma AK. Trichotillomania and trichophagia leading to trichobezoar. J Dermatol. 2000;27:24-6.

Swedo SE, Leonard HL, Rapoport JL, Lenane MC, Goldberger EL, Cheslow DL. A double-blind comparison of clomipramine and desipramine in the treatment of trichotillomania (hair pulling). N Engl J Med. 1989;321:497-501.