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Images in paediatrics
Rapunzel syndrome: the pathway for a prompt diagnosis
  1. Henedina Antunes1,2,3,
  2. Catarina Barroso2,3,4,
  3. Catarina Faria1,
  4. Jorge Correia-Pinto2,3,4
  1. 1 Gastrenterology, Hepatology and Nutrition Unit, Pediatric Department, Hospital de Braga, Braga, Portugal
  2. 2 Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
  3. 3 ICVS/3B’s - PT Government Associate Laboratory, Braga, Portugal
  4. 4 Department of Pediatric Surgery, Hospital de Braga, Braga, Portugal
  1. Correspondence to Professor Henedina Antunes, Unidade de Gastrenterologia, Hepatologia e Nutrição Pediátrica, Serviço de Pediatria, Hospital de Braga , 4710 Braga, Portugal; henedinaantunes{at}

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A 14-year-old girl with no psychiatric background presented with painful epigastric mass and vomiting. Physical examination showed emaciated appearance, epigastric swelling, hair loss and halitosis. Abdominal ultrasound identified a hyperechoic curvilinear mass with acoustic shadowing. Abdominal CT revealed a heterogeneous image in the gastric lumen, suspicious of trichobezoar (figure 1). An upper gastrointestinal endoscopy identified a ‘comet tail’ extension to duodenum suggestive of Rapunzel syndrome.

Figure 1

Abdominal tomography with a heterogeneous image in …

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  • Contributors HA, CB and CF wrote the manuscript. CB edited the images. JC-P reviewed the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Ethics approval Comissão de Ética para a Saúde do Hospital de Braga (CESHB).

  • Provenance and peer review Not commissioned; internally peer reviewed.

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