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Rapunzel syndrome: a tail too long to tell!
  1. Kashish Khanna1,
  2. Sarvesh Tandon2,
  3. Devendra Kumar Yadav1,
  4. Vikram Khanna3
  1. 1Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
  2. 2Forensic Medicine, Vardhaman Mahavir Medical College and Safdarjang Hospital, New Delhi, India
  3. 3Pediatric Surgery, Lady Hardinge Medical College, New Delhi, India
  1. Correspondence to Dr Vikram Khanna, vikramaiims{at}

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Trichobezoar leading to Rapunzel syndrome (RS) is an extremely rare entity with about 90 cases reported in literature.1 RS derives its name from the fairy tale ‘Rapunzel’, where the German princess let her long golden hair down from her tower to facilitate a tryst with her lover akin to the long and shiny tail of hair seen in RS.2 Hair being slippery gets trapped in gastric mucosal folds, eluding peristalsis. More and more hair conglomerate to form a stomach-shaped mass coated with mucus called trichobezoar. This provides it a shiny glistening surface, and the acid secreted in stomach denatures the hair protein which gives it the typical black colour.3 When the tail of hair extends beyond the stomach into the small intestine, it is called RS.

A 6-year-old girl presented to our emergency department with history of abdominal pain and recurrent vomiting for 3–4 days. On examination she was dehydrated, had tachycardia and looked malnourished. Her abdomen was grossly distended without signs of peritonitis. An X-ray abdomen (erect) showed four-air-fluid levels suggestive of acute small bowel …

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