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Rapunzel syndrome: a diagnosis overlooked
John Mathai1, Jacob Chacko, T Sathish Kumar
1Departments of Paediatric surgery, Christian Medical College and Hospital, Vellore 632004, Tamil nadu, India. sarjomat@yahoo.co.in
Acta Paediatrica (Oslo, Norway : 1992)
|December 26, 2006
Summary
Two children with Rapunzel syndrome experienced delayed diagnosis due to painless abdominal masses mimicking splenic enlargement. Early identification is crucial for pediatric patients with trichobezoars.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Imaging
Background:
- Rapunzel syndrome, a rare condition involving gastric trichobezoars with intestinal extension, often presents with vague symptoms.
- Delayed diagnosis in pediatric cases can lead to significant complications.
Observation:
- Two pediatric patients presented with painless abdominal masses, initially misdiagnosed as splenic enlargement.
- The trichobezoars had an unusual tail extending into the small intestine, characteristic of Rapunzel syndrome.
Findings:
- Painless abdominal masses in children can obscure the diagnosis of trichobezoars.
- Surgical exploration revealed trichobezoars with a tail extending into the small intestine in both cases.
Implications:
- Rapunzel syndrome diagnosis requires specific clinical suspicion in pediatric patients with abdominal masses.
- Early recognition and intervention are vital to prevent complications associated with trichobezoars.
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