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Rapunzel Syndrome: Rare 'Tale' of a Broken 'Tail'.

Chauhan NS, Kumar S, Bhoil R - Pol J Radiol (2016)

Bottom Line: In cases of this syndrome with a broken tail, CT is essential for precise count and localization of the separated fragments to ensure their complete removal at the time of surgery.We also propose to name the fragments of the broken tail as 'bezoarlets'.This word aptly describes the tail fragments as it suggests their origin from the larger gastric bezoar and the suffix 'lets' conveys they are smaller in size.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Dr. Rajendra Prasad Government Medical College, Kangra, India.

ABSTRACT

Background: Rapunzel syndrome is a rare and unique form of trichobezoar, in which a cast of hairs is formed in the stomach with its 'tail' extending up to varying lengths into the small bowel. Almost all cases described in literature are of 'classic' and more common form of Rapunzel. Sometimes however, the tail of bezoar is broken into smaller fragments. There is not much literature available on this rarer subset of Rapunzel syndrome.

Case report: In this report we present the ultrasound (USG) and CT findings of a case of Rapunzel syndrome in which the tail had broken into five separate fragments. The patient presented clinically with intestinal obstruction due to the impaction of the distal- most fragment in the ileum.

Conclusions: Our case highlights the fact that although USG features may be suggestive, a careful evaluation of CT images is essential for a confidant preoperative diagnosis of Rapunzel syndrome. In cases of this syndrome with a broken tail, CT is essential for precise count and localization of the separated fragments to ensure their complete removal at the time of surgery. We also propose to name the fragments of the broken tail as 'bezoarlets'. This word aptly describes the tail fragments as it suggests their origin from the larger gastric bezoar and the suffix 'lets' conveys they are smaller in size.

No MeSH data available.


Related in: MedlinePlus

Intraoperative photograph showing the gastric bezoar along the small bowel bezoarlets.
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f4-poljradiol-81-166: Intraoperative photograph showing the gastric bezoar along the small bowel bezoarlets.

Mentions: Patient subsequently underwent exploratory laparotomy with gastrostomy and enterotomy, under general anaesthesia. A large trichobezoar was extracted from the stomach and the smaller bezoars were milked and extracted from the ileal enterotomy site (Figure 4). The patient recovered uneventfully and was discharged after a week.


Rapunzel Syndrome: Rare 'Tale' of a Broken 'Tail'.

Chauhan NS, Kumar S, Bhoil R - Pol J Radiol (2016)

Intraoperative photograph showing the gastric bezoar along the small bowel bezoarlets.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4835156&req=5

f4-poljradiol-81-166: Intraoperative photograph showing the gastric bezoar along the small bowel bezoarlets.
Mentions: Patient subsequently underwent exploratory laparotomy with gastrostomy and enterotomy, under general anaesthesia. A large trichobezoar was extracted from the stomach and the smaller bezoars were milked and extracted from the ileal enterotomy site (Figure 4). The patient recovered uneventfully and was discharged after a week.

Bottom Line: In cases of this syndrome with a broken tail, CT is essential for precise count and localization of the separated fragments to ensure their complete removal at the time of surgery.We also propose to name the fragments of the broken tail as 'bezoarlets'.This word aptly describes the tail fragments as it suggests their origin from the larger gastric bezoar and the suffix 'lets' conveys they are smaller in size.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Dr. Rajendra Prasad Government Medical College, Kangra, India.

ABSTRACT

Background: Rapunzel syndrome is a rare and unique form of trichobezoar, in which a cast of hairs is formed in the stomach with its 'tail' extending up to varying lengths into the small bowel. Almost all cases described in literature are of 'classic' and more common form of Rapunzel. Sometimes however, the tail of bezoar is broken into smaller fragments. There is not much literature available on this rarer subset of Rapunzel syndrome.

Case report: In this report we present the ultrasound (USG) and CT findings of a case of Rapunzel syndrome in which the tail had broken into five separate fragments. The patient presented clinically with intestinal obstruction due to the impaction of the distal- most fragment in the ileum.

Conclusions: Our case highlights the fact that although USG features may be suggestive, a careful evaluation of CT images is essential for a confidant preoperative diagnosis of Rapunzel syndrome. In cases of this syndrome with a broken tail, CT is essential for precise count and localization of the separated fragments to ensure their complete removal at the time of surgery. We also propose to name the fragments of the broken tail as 'bezoarlets'. This word aptly describes the tail fragments as it suggests their origin from the larger gastric bezoar and the suffix 'lets' conveys they are smaller in size.

No MeSH data available.


Related in: MedlinePlus