జీర్ణకోశ & జీర్ణ వ్యవస్థ

నైరూప్య

Rapunzel Syndrome: A Case Report with Literature Review

Rajesh Godara, Bansal AR, Sandhya, Jaikaran, Tamaknand V and Tripura R

Background: Bezoar is a conglomeration of foreign material in the intestinal tract. Trichobezoar (accumulation of hair in the gastric chamber, secondary to impulsive pulling and intake) and Rapunzel syndrome (accumulation of hair in the small intestine) usually occur in children and adolescents with trichotillomania, trichophagia and gastric dysmotility disorder.The usual symptomatology includes vomiting and abdominal pain.

Case presentation: 18 year old female presented with complaints of dull aching epigastric pain, vomiting, loss of appetite and weight loss of 18 months duration. On examination she was emaciated having a palpable lump in epigastrium. Further examination and imaging showed a large trichobezoar. She underwent gastrotomy and extraction of hair ball. Post operative course was uneventful.

Conclusion: Early diagnosis and treatment of the Rapunzel syndrome is of eminent importance in order to avoid later fatal complications such as gastric perforation, intestinal obstruction and necrosis. Complete removal of trichobezoar and psychiatric consultation, coupled with long-term follow-up, are essential to prevent recurrence.