European Journal of Pediatrics

, Volume 168, Issue 4, pp 495–497 | Cite as

An unusual cause of gastric perforation in childhood: trichobezoar (Rapunzel syndrome). A case report

  • Orhan Koç
  • Fesih Doğan Yıldız
  • Adnan Narcı
  • Tolga Altuğ Şen
Short Report


Trichobezoars are hair balls found in the stomach and formed following trichitillomania and trichopaghia. Rapunzel syndrome is a rare condition in which the presence of giant trichobezoars causes mechanical obstruction. To date, only two cases of stomach perforation caused by trichobezoars have been reported among pediatric patients. We report a 14-year-old female patient who experienced nausea, vomiting and severe abdominal pain for 1 month. Physical examination revealed diffuse abdominal distension. Palpation detected a mobile and sensitive mass, 15 × 15 cm , which filled the upper quadrant. Urgent surgery revealed that the stomach was perforated by the trichobezoar ball. This trichobezoar mass was totally excised by expanding the perforation area. Conclusion This is the reported third case of gastric perforation caused by trichobezoar in a pediatric patient. Among acute abdominal cases, gastric perforation should remain a possibility in differential diagnosis.


Child Gastric perforation Rapunzel syndrome Trichobezoar 


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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Orhan Koç
    • 1
  • Fesih Doğan Yıldız
    • 2
  • Adnan Narcı
    • 3
  • Tolga Altuğ Şen
    • 4
  1. 1.Pediatric Surgery ClinicNazilli State HospitalNazilliTurkey
  2. 2.General Surgery ClinicNazilli State HospitalNazilliTurkey
  3. 3.Department of Pediatric Surgery, Faculty of MedicineAfyon Kocatepe UniversityAfyonkarahisarTurkey
  4. 4.Department of Pediatrics, Faculty of MedicineAfyon Kocatepe UniversityAfyonTurkey

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