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CC BY 4.0 · Surg J (N Y) 2022; 08(04): e293-e296
DOI: 10.1055/s-0042-1757777
Case Report

Rapunzel Syndrome: A Case of Trichobezoar with Small Bowel Complications

Ramakrishna Narra
1   Department of Radio-diagnosis, Katuri Medical College, Guntur, Andhra Pradesh, India
,
Anusha Guntamukkala
1   Department of Radio-diagnosis, Katuri Medical College, Guntur, Andhra Pradesh, India
,
Chanda Bhaskara Rao
2   Department of Pediatric Surgery, Guntur Medical College, Guntur, Andhra Pradesh, India
,
Tanveer Begum
3   Department of Pediatrics, Katuri Medical College, Guntur, Andhra Pradesh, India
› Institutsangaben Funding None.
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Abstract

Introduction Rapunzel syndrome is characterized by a large trichobezoar in the stomach with a tail extending beyond the pylorus into the small bowel, causing mechanical obstruction of the small bowel. A 7-year-old girl presented to the emergency room with severe epigastric pain. Computed tomography suggested trichobezoar causing jejuno-jejunal intussusceptions, bowel wall thickening, and dilated small bowel loops proximal to the obstruction. On laparotomy, two concealed perforations were noted at the duodenojejunal (DJ) junction and 40 cm distal to the DJ junction. An enterotomy incision was given at the antimesenteric border of the distal jejunal perforation site, and the mass was successfully extracted. Primary repair was done at the DJ perforation site, and resection was followed by an end-to-end anastomosis at the distal jejunal perforation site. Surgery confirmed a complex mass of tangled hair within the gastric cavity with a tail extending into the pylorus of the stomach and small intestine, consistent with trichobezoar.

Conclusion Computed tomography is superior to other radiological imaging modalities for diagnosing trichobezoars as it helps diagnose and demonstrate mechanical bowel complications.

Keywords

trichobezoar - Rapunzel syndrome - intussusceptions - contrast-enhanced computed tomography


Publikationsverlauf

Eingereicht: 29. Juni 2022

Angenommen: 12. September 2022

Artikel online veröffentlicht:
06. November 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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