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The Rapunzel syndrome is an extremely rare intestinal condition resulting from eating hair (a condition known as trichophagia) involving strands of ...

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The Rapunzel syndrome is an extremely rare intestinal condition resulting from eating hair (a condition known as trichophagia) involving strands of swallowed hair extending as a tail beyond the stomach and into the small intestine. This was first described in 1968 and as late as 2008 only 26 cases have been reported. The Rapunzel syndrome is named after the long-haired girl "Rapunzel" – the maiden in the Grimm brothers' fairy tale whose long hair flowed out of her prison tower allowing her prince to rescue her. Because the human gastrointestinal tract is unable to digest human hair, and hair, being indigestible and slippery, cannot be propulsed out of the stomach, and therefore the hair becomes entrapped within it. Large amounts of hair can thus accumulate over the years forming a hair ball called a trichobezoar, and if treatment is needed, then surgical treatment is usually required. Rapunzel Syndrome Diagnosis The diagnosis of Rapunzel syndrome is based on a combination of medical history and physical findings, a family history of psychiatric disorders, previous bezoars, a palpable mass, patchy hair loss and halitosis. The use of ultrasound (US), CT scanning, and endoscopy are essential. Using these techniques the trichobezoar may appear as a gastric obstruction and mass in the stomach. The upper part of a large bezoar may be visible as a mass with a convex upper border projecting into the otherwise normal gastric air bubble. Additionally, a standing or lying abdominal radiograph may also show a prominent gastric outline with a mottled mass, outlined by gas in the distended stomach, mimicking a food-filled stomach. With a small amount of barium the hair-ball gets coated and becomes visible. Below is a radiograph (x-ray) of a stomach after a barium meal showing filling defect (the area that is not cloudy white) due to a tricho
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