EC Clinical and Medical Case Reports

Case Report Volume 6 Issue 3 - 2023

Rapunzel Syndrome and Atypical Pancreatitis Acute Abdomen: A Case Report

Zia Danesh Jummani1*, Karim A Sarhane2, Ajit Dhake2, Suvarna Dhake3, Mahmood Shaik1, Mohammed Shaidul Islam1, Hakimuddin Jiwa Khan1 and Rahat Nasim1

1Department of Emergency, Burjeel Royal Hospital, Al Ain, Abu Dhabi, UAE

2Department of General Surgery, Burjeel Royal Hospital, Al Ain, Abu Dhabi, UAE

3Department of Radiology, Burjeel Royal Hospital, Al Ain, Abu Dhabi, UAE

*Corresponding Author: Zia Danesh Jummani, Department of Emergency, Burjeel Royal Hospital, Al Ain, Abu Dhabi, UAE.
Received: December 28, 2022; Published:February 28, 2023



Trichobezoar is a condition characterized by the accumulation of undigested hair and or other foreign bodies in the stomach. The reported occurrence is uncommon in the Middle East and usually affects female adolescents and young children. Rapunzel syndrome, which almost exclusively affects young women, is a rare form of trichobezoar in the stomach that spreads to the intestine and is associated with psychiatric disorders such as trichotillomania and trichophagia. This report describes a rare case of giant trichobezoar complicated with acute pancreatitis in a young patient which was ultimately treated with removal of trichobezoar by surgical gastrotomy.

Keywords: Trichobezoar; Trichotillomania; Trichophagia; Laparotomy; Acute Pancreatitis

  1. Hewitt AN., et al. “Gastric bezoars: reassessment of clinical and radiographic findings in 19 patients”. The British Journal of Radiology 82 (2009): 901-907.
  2. Sumskiene J., et al. “An unusual case of bleeding from stomach due to a giant diospyrobezoar”. Medicina 45 (2009): 476-479.
  3. Pogoreli´c Z., et al. “Unusual cause of palpable mass in upper abdomen-giant gastric trichobezoar: report of a case”. Acta Chirurgica Belgica2 (2012): 160-163.
  4. Matejů E., et al. “Fatal case of Rapunzel syndrome in neglected child”. Forensic Science International1-3 (2009): e5-e7.
  5. Irastorza I., et al. “A trichobezoar in a child with undiagnosed celiac disease: a case report”. World Journal of Gastroenterology5 (2014): 1357-1360.
  6. Bousfiha N., et al. “Upper gastrointestinal obstruction due to trichobezoar”. La Presse Medicale9 (2014): 1008-1009.
  7. KY Cho., et al. “Small bowel volvulus with a jejunal trichobezoar”. Indian Pediatric7 (2014): 575-576.
  8. Sehgal VN and Srivastava G. “Trichotillomania ± trichobezoar: revisited”. Journal of the European Academy of Dermatology and Venereology 20 (2006): 911-915.
  9. DeBakey M and Ochsner W. “Bezoars and concretions 1939. A comprehensive review of the literature with an analysis of 303 collected cases and a presentation of 8 additional cases”. The International Journal of Surgery 5 (1939): 132-160.
  10. Frey AS., et al. “Hair apparent: Rapunzel syndrome”. The American Journal of Psychiatry 162 (2005): 2.
  11. Al-Janabi IS., et al. “Unusual trichobezoar of the stomach and the intestine: a case report”. Journal of Medical Case Reports 8 (2014): 79.
  12. Naik S., et al. “Rapunzel syndrome reviewed and redefined”. Digestive Surgery 24 (2007): 157-161.
  13. Agrawal V., et al. “Plasticobezoar - another new entity for Rapunzel syndrome”. Indian Journal of Practical Pediatrics 76 (2009): 229-230.
  14. Erzurumlu K., et al. “Gastrointestinal bezoars: A retrospective analysis of 34 cases”. World Journal of Gastroenterology 11 (2005): 1813-1817.
  15. Alsafwah S and Alzein M. “Small bowel obstruction due to trichobezoar: Role of upper endoscopy in diagnosis”. Gastrointestinal Endoscopy 52 (2000): 784-786.
  16. Caiazzo P., et al. The Rapunzel Syndrome 37.2 (2016): 90-94.
  17. Ahmed MM., et al. “Large trichobezoar associated with misdiagnosis, a rare case report with a brief literature review”. International Journal of Surgery Case Reports 88 (2021): 106551.
  18. Haggui B., et al. “Management of trichobezoar: about 6 cases”. African Journal of Paediatric Surgery 19 (2022): 102-104.
  19. Ripollés T., et al. “Gastrointestinal bezoars: sonographic and CT characteristics”. The American Journal of Roentgenology1 (2001): 65-69.
  20. Gorter RR., et al. “Management of trichobezoar: case report and literature review”. Pediatric Surgery International5 (2010): 457-463.
  21. Gonuguntla V and Joshi DD. “Rapunzel syndrome: a comprehensive review of an unusual case of trichobezoar”. Clinical Medicine and Research 7 (2009): 99-102.
  22. Ladas SD., et al. “Systematic Review: Coca-Coal can effectively dissolve gastric phytobezoars as a first-line treatment”. Alimentary Pharmacology and Therapeutics2 (2013): 169-173.

Zia Danesh Jummani., et al. Rapunzel Syndrome and Atypical Pancreatitis Acute Abdomen: A Case Report. EC Clinical and Medical Case Reports   6.3 (2023): 15-20.