Rapunzel Syndrome Reviewed and Redefined

Abstract

Rapunzel syndrome is a rare presentation of a trichobezoar, with 24 cases having been reported in literature so far. This syndrome has been reported in 23 female and 1 male patient with a mean age of 10.8 years. The patients commonly present with abdominal pain, nausea, vomiting and signs of obstruction. The distal end of the bezoar may be in the jejunum, ileum or the colon. We evaluate the various cases reported and discuss the various modes of presentation of this uncommon syndrome, and also present a series of 3 cases, all females, aged 16, 18 and 21 years, and had a trichobezoar in the stomach with a tail extending into the ileum.

Rapunzel syndrome: The unsuspected culprit

“…In their report in 1999, Dalshaug and colleagues found only 11 cases [4] , whereas in a recent search in 2007, only 24 cases were retrieved from the literature [5] . The reason why hair collects in the stomach is not fully understood.…”

Laparoscopic Removal of a Giant Gastroduodenal Bezoar

“…[1][2][3] Large gastric bezoars may result in numerous complicationsmost commonly intestinal obstruction, failure to thrive, and iron deficiency anemia. 4 Although nonsurgical interventions exist, including NG lavage or suction, prokinetic agents, enzymatic fragmentation, and endoscopic retrieval, they are often unsuccessful in treating large trichobezoars that cause obstructive symptoms, and therefore, surgery is required.…”

A Rare Cause of Abdominal Mass: Rapunzel Syndrome

“…All but one case with Rapunzel syndrome reported in the literature were female like our patient. The cause of trichobezoar in the only male case was his sister's hair [6].…”

“…It most commonly presents with abdominal pain, nausea and vomiting, obstruction, and peritonitis. The less common symptoms of the patients include weight loss, anorexia, hematemesis [6]. Gastric ulceration, obstructive jaundice, acute pancreatitis, intestinal intusseptions are the complications caused by a large eroding or obstructing bezoar [6].…”

“…The less common symptoms of the patients include weight loss, anorexia, hematemesis [6]. Gastric ulceration, obstructive jaundice, acute pancreatitis, intestinal intusseptions are the complications caused by a large eroding or obstructing bezoar [6]. Protein-losing enteropathy, iron deficiency, and megaloblastic anemia are the other malabsorption-related complications [7].…”