Rapunzel Syndrome Causing Appendicitis in an 8-year-old Girl. 2012

Shruti Dogra, and Yogesh Kumar Yadav, and Uma Sharma, and Kusum Gupta
Department of Pathology, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi, India.

Rapunzel syndrome is a rare type of presentation of trichobezoar, an extension of hair fibers into the small bowel and rarely beyond the ileocecal valve. Its clinical presentation is deceptive ranging from abdominal mass to symptoms of obstruction. We report a 8-year-old girl admitted with a history of abdominal pain and vomiting off and on for a period of 1 year. Ultrasound findings were suggestive of subacute intestinal obstruction. On laparotomy, trichobezoar was found in the stomach extending into small bowel and was removed. Appendix was inflammed hence it was also resected. Microscopic evidence of a hair shaft was seen in the appendix indicating appendicitis was due to luminal obstruction by hair concretions.

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