Rapunzel Syndrome in a Seven-Year-Old Girl
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Rapunzel syndrome is a rare entity with less than hundred case reports cited in the literature. In this, there is presence of a trichobezoar in the stomach which extends into the small intestine or beyond. The gold standard for diagnosis is upper gastrointestinal endoscopy and treatment is surgical removal.

A seven-year-old girl presented to us with early satiety, abdominal distension, and loss of weight. There was a history of hair eating.

On examination, there was a firm well-defined lump palpable in the left hypochondrium of size 3.5 cm. CT was done with concern of a possible tumor. It showed presence of well-defined intraluminal heterogenous mass with mottled appearance present in the stomach and extending into the duodenum. Upper gastrointestinal endoscopy confirmed the mass as trichobezoar.

The patient underwent explorative laparotomy and anterior gastrotomy where trichobezoar was removed en bloc. Histopathology showed hair bundles along with vegetative material, decaying necrotic material, and many thin-walled fungal hyphae with acute angle branching.

The management and treatment of a Rapunzel syndrome encompass surgical removal of the mass and prevention of recurrence by addressing the underlying psychiatric disorder. Surgical removal is accomplished by gastrotomy or enterotomy.

Indian Journal of Surgery
Source: https://doi.org/10.1007/s12262-021-02788-0
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