IRON DEFICIENCY ANEMIA AND HYPOALBUMINEMIA SECONDARY TO A RARE CASE OF RAPUNZEL SYNDROME.

Abstract

Background: The term '' RAPUNZEL SYNDROME '' was coined by Vaughan and associates in 1968 for unusual manifestation of a trichobezoar in which the mass extends from the stomach and duodenum through a large portion of small intestine.Bezoars are collection of non-digestible foreign bodies such as hair that usually accumulate in gastrointestinal tract.Trichobezoar is underdiagnosed entity that has to be considered in childrens and adolescents especially females, suffering from trichotillomania(compulsion to pull hair) and trichophagia (compulsion to swallow hair) When undiagnosed, gastric bezoars may also cause severe anemia either due to malabsorption or gastrointestinal bleeding. 1)To Objectives: emphasize the presentation and focus on prompt diagnostic ndings in a case of Rapunzel syndrome. 2) To explain the need of routine biochemical investigations like S. Iron, S. Ferritin, S. Albumin, S. Globulin, Total proteins in case of Rapunzel syndrome so as prevent further complications. Methodology: A 17 year old female presented to casualty with complaints of pain in epigastric region since 4 months which was spasmodic on and off in nature and non-radiating. History of nausea and vomitings and histrory of strange behaviour noticed by guardians-plucking hair and swallowing.USG suggested hyperechoic curvilinear dense strip with acoustic shadowing.CT scan shows an intragastric well circumscribed inhomogenous mass consisting of mottled gas pattern. patient was diagnosed wit Result: h Rapunzel syndrome associated with iron deciency anemia and hypoalbuminemia. Rapunzel syndrome is a rare entity that can be com Conclusion: plicated with life threatening events.A prompt diagnosis of trichobezoar so as to prevent deciencies which may lead to complications.