PEDIATRIC GASTROENTEROLOGY, HEPATOLOGY & NUTRITION A Case of Rapunzel Syndrome

Rapunzel syndrome refers to a very rare condition in which swallowed hair forms a gastric trichobezoar that has a long tail extending into the small bowel. We describe a case of Rapunzel syndrome in an 8-year-old girl who pre-sented with abdominal mass, epigastric pain and vomiting. Abdominal computed tomography scan showed a mark-edly dilated stomach filled with coarse heterogeneous materials. Upper gastrointestinal endoscopy revealed a huge hairy ball with a tail extending through the pylorus. We performed a surgical laparotomy and successfully removed a huge trichobezoar with a long tail extending into the middle portion of jejunum. Psychiatric consultation with review showed her past history of trichotillomania and trichophagia 4 years ago. But her parents denied further psychiatric therapy and she was lost to the follow-up. Rapunzel syndrome should be included in the differential diagnosis in children with chronic abdominal pain and trichophagia. (Pediatr Gastroenterol Hepatol Nutr 2013; 16: 127∼130