Case Report

Rapunzel Syndrome—A Rare Cause of Multiple Jejunal Intussusception

Authors: Rizwan Kibria MD, Sonia Michail MD, Syed A. Ali MD

Abstract

Abstract:Trichobezoars are usually without symptoms until they reach a large size. The “Rapunzel” syndrome is a trichobezoar with a long tail extending from the stomach to small bowel. We report the case of a 6-year-old girl with a history of trichotillomania and hair ingestion for three years, who presented with multiple jejunojejunal intussusceptions due to a trichobezoar with a long, 90-cm tail into the small bowel. To our knowledge, this is the first report of trichobezoars as a cause of jejunal intussusceptions, which should be suspected in the appropriate clinical circumstances.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

References1. Hunt M. Grimm’s Household Tales. London, G. Bell, 1984.HuntMGrimm’s Household Tales.LondonG. Bell19842. De Bakey M, Oschner A. Bezoars and concretions: comprehensive review of literature, with analysis of 303 collected cases and presentation of eight additional cases. Surgery 1939,5:132–160.De BakeyM]]OschnerABezoars and concretions: comprehensive review of literature, with analysis of 303 collected cases and presentation of eight additional cases.Surgery19395132-1603. Dalshaug GB, Wainer S, Hollaar GL. The Rapunzal syndrome (trichobezoar) causing atypical intussusception in a child: a case report. J Pediatr Surg 1999;34:479–480.DalshaugGB]]WainerS]]HollaarGLThe Rapunzal syndrome (trichobezoar) causing atypical intussusception in a child: a case report.J Pediatr Surg199934479-4804. Zent RM, Cothren CC, Moore EE. Gastric trichobezoar and rapunzal syndrome. J Am Coll Surg 2004;199:990.ZentRM]]CothrenCC]]MooreEEGastric trichobezoar and rapunzal syndrome.J Am Coll Surg20041999905. Deslypere JP, Praet M, Verdonk G. An unusual case of trichobezoar: the rapunzal syndrome. Am J Gastroenterol 1982;77:467–470.DeslypereJP]]PraetM]]VerdonkGAn unusual case of trichobezoar: the rapunzal syndrome.Am J Gastroenterol198277467-4706. Wolfson PJ, Fabius RJ, Leibowitz AN. The Rapunzal syndrome: an unusual trichobezoar. Am J Gastroenterol 1987;82:365–367.WolfsonPJ]]FabiusRJ]]LeibowitzANThe Rapunzal syndrome: an unusual trichobezoar.Am J Gastroenterol198782365-3677. Wadlington WB, Rose M, Holocomb GW Jr. Complications of trichobezoars: a 30-year experience. South Med J 1992;85:1020–1022.WadlingtonWB]]RoseM]]HolocombGWJrComplications of trichobezoars: a 30-year experience.South Med J1992851020-10228. Klipfel AA, Kessler E, Schein M. Rapunzal syndrome causing gastric emphysema and small bowel obstruction. Surgery 2003;133:120–121.KlipfelAA]]KesslerE]]ScheinMRapunzal syndrome causing gastric emphysema and small bowel obstruction.Surgery2003133120-1219. Duncan ND, Aitken R, Venogopal S, et al. The Rapunzal syndrome. Report of a case and review of literature. West Indian Med J 1994;43:63–65.DuncanND]]AitkenR]]VenogopalS&etal;The Rapunzal syndrome. Report of a case and review of literature.West Indian Med J19944363-6510. Balik E, Ulman I, Taneli C, et al. The Rapunzal syndrome: a case report and review of the literature. Eur J Pediatr Surg 1993;3:171–173.BalikE]]UlmanI]]TaneliC&etal;The Rapunzal syndrome: a case report and review of the literature.Eur J Pediatr Surg19933171-17311. Uroz Tristán J, García Urgellés X, Melián Pérez-Marín S. [Rapunzal syndrome: a report of a new case]. Cir Pediatr 1996;9:40–41 [in Spanish].12. Spalding SC, Evans B. Intussusceptions. Emerg Med 2004;36:12–19.SpaldingSC]]EvansBIntussusceptions.Emerg Med20043612-1913. Freilich EB, Coe GC. Jejunal intussusception. Ann Surg 1937;105:183–191.FreilichEB]]CoeGCJejunal intussusception.Ann Surg1937105183-191