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Rapunzel syndrome in adult with mysterious presentation: a rare case report with literature review.
Trop Doct 2019; 49(2):133-135TD

Abstract

Bezoars are indigestible foreign material in the gastrointestinal tract (GIT). A phytobezoar is a mass of plant material, while a trichobezoar consists of matted hair. This is found most commonly in the stomach in children who chew their long hair. When a gastric trichobezoar extends to the duodenum or jejunum, this is known as Rapunzel syndrome (RS), after a famous Brothers' Grimm fairy tale. Our patient presented with haematemesis, localised peritonitis, a palpable epigastric mass, coagulopathy, severe anaemia and deranged liver function tests. An abdominal computed tomography scan was suggestive of a bezoar; gastroduodenoscopy confirmed the diagnosis. Treatment of trichobezoars normally involve endoscopic removal or gastrotomy and psychiatric intervention. They may also cause haematemesis, gastric outlet obstruction, gastric ulceration and perforation, multiple jejuno-jejunal intussusception, acute pancreatitis and cholestatic jaundice. Trichobezoar was first reported in the 18th century by Baudamant in a 16-year-old boy. RS was first described in 1968.

Authors+Show Affiliations

1 Assistant Professor, Department of General Surgery, All India Institute of Medical Sciences Rishikesh, India.2 Associate Professor, Department of General Surgery, All India Institute of Medical Sciences Rishikesh, India.3 Associate Professor, Department of Gastroenterology, All India Institute of Medical Sciences Rishikesh, India.4 Additional Professor, Department of Anaesthesiology, All India Institute of Medical Sciences Rishikesh, India.5 Senior Resident, Department of General Surgery, All India Institute of Medical Sciences Rishikesh, India.6 Junior Resident, Department of General Surgery, All India Institute of Medical Sciences Rishikesh, India.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

30722745

Citation

Kumar, Navin, et al. "Rapunzel Syndrome in Adult With Mysterious Presentation: a Rare Case Report With Literature Review." Tropical Doctor, vol. 49, no. 2, 2019, pp. 133-135.
Kumar N, Huda F, Gupta R, et al. Rapunzel syndrome in adult with mysterious presentation: a rare case report with literature review. Trop Doct. 2019;49(2):133-135.
Kumar, N., Huda, F., Gupta, R., Payal, Y. S., Kumar, U., & Mallik, D. (2019). Rapunzel syndrome in adult with mysterious presentation: a rare case report with literature review. Tropical Doctor, 49(2), pp. 133-135. doi:10.1177/0049475519826477.
Kumar N, et al. Rapunzel Syndrome in Adult With Mysterious Presentation: a Rare Case Report With Literature Review. Trop Doct. 2019;49(2):133-135. PubMed PMID: 30722745.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rapunzel syndrome in adult with mysterious presentation: a rare case report with literature review. AU - Kumar,Navin, AU - Huda,Farhanul, AU - Gupta,Rohit, AU - Payal,Y S, AU - Kumar,Utkarsh, AU - Mallik,Dhiraj, Y1 - 2019/02/05/ PY - 2019/2/7/pubmed PY - 2019/2/7/medline PY - 2019/2/7/entrez KW - Rapunzel syndrome KW - Trichobezoars SP - 133 EP - 135 JF - Tropical doctor JO - Trop Doct VL - 49 IS - 2 N2 - Bezoars are indigestible foreign material in the gastrointestinal tract (GIT). A phytobezoar is a mass of plant material, while a trichobezoar consists of matted hair. This is found most commonly in the stomach in children who chew their long hair. When a gastric trichobezoar extends to the duodenum or jejunum, this is known as Rapunzel syndrome (RS), after a famous Brothers' Grimm fairy tale. Our patient presented with haematemesis, localised peritonitis, a palpable epigastric mass, coagulopathy, severe anaemia and deranged liver function tests. An abdominal computed tomography scan was suggestive of a bezoar; gastroduodenoscopy confirmed the diagnosis. Treatment of trichobezoars normally involve endoscopic removal or gastrotomy and psychiatric intervention. They may also cause haematemesis, gastric outlet obstruction, gastric ulceration and perforation, multiple jejuno-jejunal intussusception, acute pancreatitis and cholestatic jaundice. Trichobezoar was first reported in the 18th century by Baudamant in a 16-year-old boy. RS was first described in 1968. SN - 1758-1133 UR - https://www.unboundmedicine.com/medline/citation/30722745/Rapunzel_syndrome_in_adult_with_mysterious_presentation:_a_rare_case_report_with_literature_review_ L2 - http://journals.sagepub.com/doi/full/10.1177/0049475519826477?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -