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CASE REPORT   

Il Giornale Italiano di Radiologia Medica 2019 Maggio-Giugno;6(3):220-4

DOI: 10.23736/S2283-8376.19.00184-0

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English, Italian

Rapunzel Syndrome: a rare case of acute abdomen associated with gastric perforation

Giulia C. PREZIOSA 1, 2 , Giuseppe PEZZOTTA 1, 2, Cesare MORZENTI 1, 2, Clarissa VALLE 1, 2, Alessandra SURACE 1, 2, Maurizio BALBI 1, 2, Sandro SIRONI 1, 2

1 Postgraduate School of Radiology, University of Milano-Bicocca, Milan, Italy; 2 Department of Radiology, ASST Papa Giovanni XXIII, Bergamo, Italy


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Trichobezoars are rare form of bezoars, which consist of ingested hairballs, hair-like fibres or other indigestible foreign materials. These foreign matters accumulate usually in the stomach. Trichobezoars rarely pass through the duodenum or the jejunum: this condition is called the Rapunzel Syndrome, with reference to Grimms’ fairy tale. The aim of this case report is to illustrate a rare case of trichobezoar extended over the jejunum (Rapunzel Syndrome) associated with gastric perforation. Gastric perforation is usually a late symptom and is a dangerous complication of this pathology. The simultaneous presence of Rapunzel Syndrome and gastric perforation is really rare. Only few cases were presented in the literature. We present a case of a 17-year-old girl, without a significant medical history. She came to our emergency department complaining diffused and intense abdominal pain. No fever neither vomit. Abdominal ultrasound, x-rays and computed tomography were performed while endoscopic exams weren’t performed because they weren’t available. These exams showed the presence of a voluminous mass in the stomach compatible with bezoar and a gastric perforation. She underwent emergency laparotomy: a mass of 1500 g, which took the shape of the stomach, was removed. Histological exam confirmed the diagnosis of trichobezoario. The girl underwent psychiatric consultation which revealed the presence of psychiatric disorders.


KEY WORDS: Bezoars; Trichotillomania; Abdominal injuries; Stomach diseases

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