Pediatr Emerg Med J.  2019 Jun;6(1):17-20. 10.22470/pemj.2019.00010.

A rare presentation of Rapunzel syndrome with multiple small bowel intussusceptions

Affiliations
  • 1Department of Emergency Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea. g3marine@naver.com
  • 2Department of Pediatrics, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
  • 3Department of General Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.

Abstract

Rapunzel syndrome is caused by gastric trichobezoar with extended tail and small bowel obstruction. Patients with gastric trichobezoar can be asymptomatic until the bezoar increases in size. We report a case of a girl who visited the emergency department with abdominal pain. She was finally diagnosed with Rapunzel syndrome that causes multiple small bowel intussusceptions associated with trichophagia. Surgery was needed to reduce the multiple intussusceptions, and to remove the large trichobezoar. This case highlights to consider the possibility of Rapunzel syndrome when diagnosing the main cause of intussusceptions.

Keyword

Bezoars; Intestinal Obstruction; Intussusception; Pica; Trichotillomania
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