The Rapunzel syndrome: is it an Asian problem? (case report and review of literature)

Trichobezoars are intraluminal accretions of ingested hair. The Rapunzel syndrome is a rare form of gastric trichobezoar, with extension into the small bowel, and may be complicated by obstruction, perforation or peritonitis. The majority of reported cases are from Asian countries. We describe the second case from England who, like the earlier report, is also a 14-year old Asian girl who presented with small bowel obstruction. The pathology was missed 2 years previously when she presented with slim stature, iron-deficiency anaemia and frontal alopecia. This report highlights the need for a higher index of suspicion, particularly in Asian girls to avoid missing the diagnosis and early elective intervention. Eur J Gastroenterol Hepatol 21:937-940 (C) 2009 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.