Rapunzel syndrome

When Rapunzel syndrome - named after the fairy tale Rapunzel by the Brothers Grimm - is it a in the medical literature rarely treated syndrome ( first described by Vaughan 1968). By the year 1999 eleven cases have been reported worldwide. The syndrome is mainly found in younger girls with trichophagia whose psychodynamic background often an expression of early childhood deprivation with high comorbidity in severe child psychiatric diseases (Gockel 2003).

The symptoms of the syndrome are nonspecific and may mimic other gastrointestinal disorders: movable tumor in the upper abdomen, weight loss, alopecia. They are triggered by a trichobezoar ( hairball ) of the stomach, which can range up into the colon with " zopfartiger " extension to the small intestine, in the extreme case. Complications fatal gastric perforation, intestinal obstruction or Wandnekrosen of the small intestine can occur.

Treatment is by surgical removal ( gastrotomy ) of Trichobezoars.

90 % of trichobezoars be with girls who are younger than 20 years, found, at which a trichotillomania is usually. Since the trichophagia occurs much more frequently than the formation of a Trichobezoars, the reasons for its occurrence are largely unknown. In addition to the amount and length of swallowed hair and a change in the Schleimhautkrypten the stomach secretions or those likely to be of crucial importance.