RT Journal Article
SR Electronic
T1 Gastric perforation secondary to Rapunzel syndrome
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e240100
DO 10.1136/bcr-2020-240100
VO 14
IS 2
A1 Jamaall Jackman
A1 Gael R Nana
A1 James Catton
A1 Ioannis Christakis
YR 2021
UL http://casereports.bmj.com/content/14/2/e240100.abstract
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.