title: Rapunzel syndrome resulting in gastric perforation.
abstract: We report the case of an 18-year-old female patient with no past medical history who presented to the emergency department with acute abdominal pain and vomiting on the background of a long history of ingesting hair (trichophagia). Computed tomography revealed pneumoperitoneum and free fluid in keeping with visceral perforation. In addition, a large hair bolus was seen extending in contiguity from the stomach to the jejunum. A laparotomy was performed, revealing an anterior gastric perforation secondary to a 120cm long trichobezoar, which had formed a cast of the entire stomach, duodenum and proximal jejunum. The bezoar was removed and an omental patch repair to the anterior ulcer was performed. The patient made an excellent postoperative recovery and was discharged home with psychiatric follow-up review.
authors.affiliation: Mid Cheshire Hospitals NHS Foundation Trust , UK.
authors.forename: J S
authors.initials: JS
authors.lastname: Parakh
authors.affiliation: Mid Cheshire Hospitals NHS Foundation Trust , UK.
authors.forename: A
authors.initials: A
authors.lastname: McAvoy
authors.affiliation: Mid Cheshire Hospitals NHS Foundation Trust , UK.
authors.forename: D J
authors.initials: DJ
authors.lastname: Corless
mesh_terms: D000293:Adolescent; D001630:Bezoars / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006197:Hair; D006801:Humans; D007813:Laparotomy / Q000379:methods; D013270:Stomach; D013275:Stomach Rupture / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D014256:Trichotillomania / Q000150:complications*
keywords: Bezoar; Gastric perforation; Rapunzel syndrome; Trichophagia; Trichotillomania