The Rapunzel Syndrome: A Hard-To-Swallow Tale

Abstract

A 27-year-old patient was investigated after an upper gastro-intestinal tract obstruction. Computed tomography and endoscopy showed a large gastric trichobezoar with a duodenojejunal tail. Conservative treatments failed to remove the bezoar. We performed a short laparotomy which allowed the removal of the bezoar through a longitudinal gastrotomy. Postoperative course was uneventful.

Usual and unusual causes of pediatric gastric outlet obstruction

“…Trichobezoars can cause significant gastric distention and outlet obstruction and are occasionally associated with long small-bowel "tails," i.e. Rapunzel syndrome [56,57].…”

Rapunzel syndrome: the pathway for a prompt diagnosis

“…In Rapunzel syndrome, the trichobezoar extends through the pylorus into the small or even the large bowel, with <50 cases reported. At an early stage, most trichobezoars are asymptomatic or have non-specific presentation, but trichobezoar growth increases the risk of complications, including mucosal erosion, ulceration and perforation 1 2…”

Letters to the Editor The giant in the stomach – trichobezoar

“…Gastric trichobezoar with a duodenal or duodenojejunal tail is named Rapunzel syndrome after the 1812 German tale written by the Grimm brothers (also known as an animated musical film by Walt Disney Studios), where a girl with long-braided hair used it to help her lover climb the tower where she was imprisoned [13]. It is a rare form of trichobezoar.…”