Cuttack: A unique case of Rapunzel syndrome was recently reported at Shanti Memorial Hospital, in
a young girl of 13 .Rapunzel Syndrome is the compulsion of young girls pulling out their own hair
and swallow or chew it, referred to as trichotillomania and trichophagia. It’s a disorder that affects
young girls with or without known psychiatric disorders. These chewed hairs consequently develop
into gastric trichobezoars ( Hairball) which takes the shape of the stomach & extends beyond the
duodenum past the small intestine, and sometimes even into the colon producing a long tail-like
extension of hair.
This syndrome is named after Rapunzel, the long haired girl in the fairy tale written by the Grimm
Brothers in 1812. It tells about a 12-year-old princess who was locked in a tower without stairs or
doors and managed to escape with the help of Rapunzel’s long tresses.
The patient came with symptoms of pain in the epigastric region since 1 month and intermittent
vomiting after taking solid food.The CT SCAN showed a distended stomach that had a soft tissue
mass of size 12cm X 6cm with entrapped air foci, which extended from body to pyloric region
.Endoscopy revealed a large mass occupying the whole stomach, starting from GE Junction upto the
3 rd part of duodenum. Post diagnosis, the patient went through a laparoscopic gastrotomy and the
trichobezoar mass (ball of hair)was removed & put into an endo bag & removed by a mini
laparatomy. The removed specimen was 28 CM long and weighed 236 GMS
The patient recovered completely and went home within a couple of days.
Treating Surgeon ,Dr Sreejoy Patnaik said, “This is the first case of Rapunzel Syndrome that has been
reported in our hospital. It is indeed a rare and unique condition. These patients usually require
psychiatric evaluation and treatment due to the association with impulsive control disorders,
especially trichotillomania. Hence we have advised long-term follow up as well as psychiatric
consultation to prevent the event from repeating.”
