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Case Reports
. 2017 Sep;11(9):TD01-TD02.
doi: 10.7860/JCDR/2017/28593.10594. Epub 2017 Sep 1.

Rapunzel Syndrome

Sneha Lalith  1 , Karunya Lakshmi Gopalakrishnan  2 , Gurubharath Ilangovan  3 , Anandapadmanabhan Jayajothi  4
Affiliations
Case Reports

Rapunzel Syndrome

Sneha Lalith et al. J Clin Diagn Res. 2017 Sep.

Abstract

A bezoar refers to a mass of undigestible foreign material found in the gastrointestinal tract, mainly stomach. The second most common bezoar is the trichobezoar, which usually occurs in the young psychiatric female patients with history of trichotillomania and trichophagia. This is a case report of a 12 -year-old female patient came with complaints of diffuse abdominal pain, vomiting, and constipation. Ultrasound, Barium X-ray and Computed Tomography scan were done, which suggested trichobezoar. Thus, trichobezoar should be considered as differential diagnosis of abdominal pain in young female patients with associated psychiatric complaints. A review is presented here, as a high index of suspicion for better diagnostic facilities which can help in timely diagnosis and intervention, to prevent further complications like intestinal obstruction, perforation and mortality in such children.

Keywords: Abdominal mass; Mental retardation; Trichobezoar.

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Figures

[Table/Fig-1]:
[Table/Fig-1]:
Plain X-ray – Distended J shaped stomach with air fluid levels at the level of fundus and second part of duodenum.
[Table/Fig-2]:
[Table/Fig-2]:
USG abdomen: Curvilinear echogenic mobile shadow in the stomach with dense posterior acoustic shadow.
[Table/Fig-3]:
[Table/Fig-3]:
a) Barium swallow oesophageal phase showing normal oesophagus and gastroesophageal junction; b,c) Supine radiograph follow through shows intraluminal defect with mottled gas pattern without attachment to stomach wall; d) Oblique view showing intralumianl defect; e) Supine view with intraluminal filling defect, contrast seen in duodenum.
[Table/Fig-4]:
[Table/Fig-4]:
a,b) Non contrast CT abdomen at the level of stomach shows a diffuse intragastric mass extending from the fundus of stomach till the second part of the duodenum consisting of “compressed concentric rings”. The lesion appears heterodense with entrapped air and food debris; c,d) Contrast enhanced CT shows contrast coating the lesion.
[Table/Fig-5]:
[Table/Fig-5]:
Postoperative specimen of trichobezoar measuring 8 cm x 3 cm x 4 cm with a thin strand of hair extending to the small bowel.
See this image and copyright information in PMC

References

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