J Korean Soc Radiol.  2018 May;78(5):345-348. 10.3348/jksr.2018.78.5.345.

Rapunzel Syndrome: Sonography and Computed Tomography of Trichobezoar

• Wijaya AT
• Atmadja B

• KMID: 2410724
• DOI: http://doi.org/10.3348/jksr.2018.78.5.345

Abstract

Trichobezoar is caused by hair ingestion that accumulates in the gastrointestinal tract. It is associated with psychiatric disorders. Occasionally, the hairs invade through pylorus and cause obstruction, which is known as Rapunzel Syndrome. A 9-year-old girl was admitted with signs of intestinal obstruction and a lump at her left side abdomen. Patient had history of trichotillomania and trichophagia. Abdominal ultrasonography and enhanced abdominal computed tomography were performed, which revealed a hair ball. Trichobezoar and Rapunzel Syndrome are bizarre and uncommon diseases. The case demonstrated that imaging modalities can accurately diagnose these diseases.

MeSH Terms

Abdomen
Bezoars*
Child
Eating
Female
Gastrointestinal Tract
Hair
Humans
Intestinal Obstruction
Pylorus
Tomography, X-Ray Computed
Trichotillomania
Ultrasonography

Figure

• 

  Fig. 1 A 9-year-old girl with signs of intestinal obstruction, a lump at her left side abdomen and history of trichotillomania and trichophagia. A. Sonogram of left upper abdomen shows hyperechoic curvilinear casting with clear posterior acoustic shadow. B-D. (B) and (C) Axial and coronal section of non-contrast CT show intragastric mass with heterogeneous density and air-bubble within it (D) and (E). On enhanced CT, there is no enhancement in the mass. CT = computed tomography F. The hair ball had 11 cm long of gastric part and 6 cm long of duodenum part. It has a perfect cast of the stomach, pylorus, and superior part of duodenum with weight about 1 kg.

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