Rapunzel Syndrome: The not-so-fairy tale of a long tail

Abstract

Background: Rapunzel Syndrome associated with Trichobezoar secondary to a psychiatric illness Trichotillomania, is often a rare diagnosis of Gastrointestinal symptoms, occurring predominantly in young & adolescent females. Clinical Description: We present here a case of such disease in a 12-year-old female who presented to us with recurrent vomiting & pain abdomen for the last 2 months. Management & Outcome: On thorough examination & investigations, she was suspected to be a case of trichobezoar on ultrasound abdomen, which was confirmed by upper GI endoscopy. Mass was surgically removed from the patient’s abdomen with a long tail of Rapunzel. Conclusion: Although trichobezoar is a rare condition, it must be considered in patients with trichotillophagia & abdominal symptoms. Symptomatic trichobezoars are often so large that they are palpable on simple clinical examination as in this case. USG may be inconclusive and endoscopy is confirmative. Undiagnosed or untreated trichobezoar continues to grow in size & weight, resulting in devastating complications, such as gastric ulcers, perforation, or even death.

Keywords

• trichobezoar
• trichotillomania
• trichotillophagia
• rapunzel syndrome