PT  - JOURNAL ARTICLE
AU  - Jackman, Jamaall
AU  - Nana, Gael R
AU  - Catton, James
AU  - Christakis, Ioannis
TI  - Gastric perforation secondary to Rapunzel syndrome
AID  - 10.1136/bcr-2020-240100
DP  - 2021 Feb 01
TA  - BMJ Case Reports
PG  - e240100
VI  - 14
IP  - 2
4099  - http://casereports.bmj.com/content/14/2/e240100.short
4100  - http://casereports.bmj.com/content/14/2/e240100.full
SO  - BMJ Case Reports2021 Feb 01; 14
AB  - Rapunzel syndrome is rare and describes a trichobezoar that extends through the pylorus into the jejunum, ileum or even the colon. Due to the large intraluminal size and weight they can attain, acute presentations of obstruction or perforation may occur. We report a case of a 17-year-old girl who presented to the emergency department following a syncopal episode. On examination, a left upper quadrant mass was appreciated with no signs of peritonism. Contrast-enhanced CT demonstrated a giant trichobezoar with resulting gastric perforation and intra-abdominal free fluid. Laparotomy and gastrotomy were performed and the patient had an uneventful recovery with psychiatric review prior to discharge. Though uncommon, bezoars should be included in our differential diagnosis as they can present in various ways owing to their size and weight. This case illustrates the risk of gastric perforation with large gastric bezoars.