title: Rapunzel syndrome in a pediatric patient: a case report.
abstract: This case report describes a 2.5-year-old girl who was hospitalized with complaints of abdominal pain and vomiting for 2 days. Abdominal ultrasound revealed small bowel-to-small bowel intussusception. Diagnostic laparoscopic-assisted exploration of the abdomen revealed 4 separate intestinal intussusceptions along with multiple dark intraluminal masses within the small intestine. Laparoscopic reduction of the intussusceptions was unsuccessful. Laparotomy allowed palpation of the entire small intestine with extraction of the masses, which were found to be human hair (trichobezoars). The intussusceptions were reduced, and the multiple masses were removed through a single enterotomy. The child recovered following surgery and was discharged home to her family. The surgeon counseled the parents before discharging the patient and recommended follow-up counseling for their child. The parents were given information about trichophagia and strategies to reduce the behavior in their child. A comprehensive literature review revealed this to be the youngest reported case of intussusception and Rapunzel syndrome due to trichobezoars.
authors.affiliation: Duke Raleigh Hospital, Raleigh, North Carolina, USA. toomescrna@gmail.com
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Middleton
authors.forename: Lynn Fitzgerald
authors.initials: LF
authors.lastname: Macksey
authors.forename: J Duncan
authors.initials: JD
authors.lastname: Phillips
mesh_terms: D001630:Bezoars / Q000150:complications* / Q000601:surgery*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007443:Intussusception / Q000209:etiology* / Q000601:surgery*; D010535:Laparoscopy; D009719:Nurse Anesthetists