Table 1.
Characteristic findings of previously reported cases of Rapunzel syndrome
| Case no. | Author | Age/sex | Presentation | Location | Complication | Underlying condition | Intervention |
|---|---|---|---|---|---|---|---|
| 1 | Bouwer and Stein3 | 25/F | Abdominal pain, nausea, vomiting | Stomach appendix | Appendicitis | Depression | Appendectomy |
| 2 | Frey et al4 | 7/F | Pallor | Stomach, duodenum | Anaemia | Parental marital discord | Laparotomy |
| 3 | Naik et al6 | 16/F | Abdominal pain | Stomach to ileum | Obstruction | Trichophagia | Laparotomy |
| 4 | Naik et al6 | 18/F | Abdominal pain, vomiting | Stomach to mid ileum | Peritonitis | Trichophagia | Laparotomy |
| 5 | Naik et al6 | 21/F | Abdominal pain, vomiting | Stomach to ileum | Peritonitis | Trichophagia | Laparotomy |
| 6 | Vaughan et al7 | 15/F | No detail available | Jejunum to colon | Obstruction | NA | No detail available |
| 7 | Vaughan et al7 | 13/F | No detail | Jejunum to ileocecal valve | Peritonitis | NA | No detail |
| 8 | Hossenbocus and Colin-Jones8 | 20/M | Oedema of legs | Stomach, duodenum, oesophagus | Protein-losing enteropathy, gastric polyposis | Mental retardation | Laparotomy |
| 9 | Neychev et al9 | 26/F | Nausea, constipation, abdominal discomfort | Oesophagus, stomach, duodenum | Chronic obstruction | Mental retardation | Laparotomy |
| 10 | Petrović et al10 | 19/F | Abdominal pain, nausea, vomiting, heart burn | Stomach, duodenum | Weight loss, anaemia | Major depression | Laparotomy |
| 11 | Jones et al11 | 37/F | Abdominal pain, vomiting, nausea | Stomach, duodenum, ileum | Recurrent pancreatitis | Stress, anxiety | Laparotomy |
| 12 | Wadlington et al12 | 30/F | Abdominal pain, vomiting | Duodenum, jejunum | Weight loss, jejunal ulcer | Bulimia | Laparotomy |
| 13 | Seker et al13 | 6/F | Nausea vomiting | Stomach to caecum | Cachexia | Mental retardation | Laparotomy |
| 14 | Ventura et al14 | 5/F | Cardiorespiratory arrest | Stomach and small bowel | Perforation of ileum, sepsis, death | Child neglect | Autopsy |
| 15 | Pul and Pul15 | 12/F | Anorexia, vomiting, constipation | Stomach to the ileum | Perforation of stomach, weight loss | Depression | Laparotomy |
| 16 | Dalshaug et al16 | 7/F | Abdominal pain, nausea, vomiting, diarrhoea | Jejunum, ileum, transverse colon | Intussusception | NA | Laparotomy |
| 17 | Sood et al17 | 7/F | Abdominal mass | Stomach to the jejunum | Alopecia | NA | Laparotomy |
| 18 | Sood et al17 | 6/F | Abdominal pain, vomiting | Stomach, duodenum | Intestinal obstruction | NA | Laparotomy |
| 19 | Gorter et al18 | 9/F | Vomiting, palpable mass | Stomach, jejunum | Intussusception | Mental disturbance | Endoscopy |
| 20 | Tiwary et al19 | 10/F | Epigastric pain, vomiting | Stomach to the jejunum | Anaemia, intestinal obstruction | NA | Laparotomy |
| 21 | Javora et al20 | 15/F | Abdominal pain | Stomach, duodenum | Peritonitis, gastric perforation | NA | Laparotomy |
| 22 | Bège et al21 | 27/F | Abdominal pain | Stomach to jejunum | Obstruction | NA | Laparotomy |
| 23 | Crawley and Guillerman22 | 12/F | Abdominal pain | Duodenum, jejunum | Obstruction | Cerebral palsy | Laparotomy |
| 24 | Bashir et al23 | 8/F | Abdominal pain | Stomach to jejunum | Obstruction | NA | Laparotomy |
| 25 | Morales-Fuentes et al24 | 22/F | Abdominal pain, nausea vomiting | Stomach, small intestine | Anaemia, weight loss | NA | Laparotomy |
| 26 | Deslypere et al25 | 14/F | Nausea and vomiting | Stomach to colon | No detail available | NA | No detail available |
| 27 | Buyukunal et al26 | 5/F | No detail available | No details available | Sepsis | NA | No detail available |
| 28 | Wolfson et al27 | 5/F | No detail available | Stomach to caecum | Volvulus | NA | No detail available |
| 29 | Hassan and Panesar28 | 5/F | Epigastric pain, vomiting | Stomach to ileocecal valve | Jejunal perforation, Weight loss | NA | No detail available |
| 30 | Balik et al29 | 15/F | Abdominal pain, anorexia | Stomach to the jejunum | Obstruction | Trichophagia | Laparotomy |
| 31 | Duncan et al30 | 5/F | No detail available | Stomach to the ileocecal valve | Intussusception | Emotional stress | Laparotomy |
| 32 | Uroz et al31 | 8/F | Vomiting, asthenia | Stomach to jejunum | Obstruction | NA | Laparotomy |
| 33 | Senapati and Subramanian32 | 8/F | Abdominal pain | Stomach to the jejunum | Haematemesis | NA | No detail available |
| 34 | Singla et al33 | 9/F | Abdominal pain, abdominal lump | Stomach to the ileum | Weight loss | NA | Laparotomy |
| 35 | Kaspar et al34 | 12/F | Uncharacterised abdominal symptoms | Stomach to the ileum | Obstruction, weight loss | NA | Endoscopy followed by laparotomy |
| 36 | Faria et al35 | 7/F | Vomiting, abdominal pain, fever | Stomach to the jejunum | Peritonitis, jejunal perforation | NA | Laparotomy |
| 37 | Hirugade et al36 | 6/M | Vomiting, abdominal pain, abdominal lump | Stomach to the ileum | Weight loss | NA | Laparotomy |
| 38 | Couper37 | 4/F | Epigastric pain | Stomach to jejunum | Obstruction | NA | Laparotomy |
| 39 | Curioso et al38 | 22/F | Not available | No details | None | NA | No details |
| 40 | Klipfel et al39 | 14/F | Vomiting, abdominal pain | Stomach separate in terminal ileum | Gastric emphysema | NA | Laparotomy |
| 41 | Memon et al40 | 12/F | Abdominal pain, and lump | Stomach to the jejunum | Jejunal perforation | Emotional disorder | Laparotomy |
| 42 | Gockel et al41 | 4/F | Abdominal pain | Stomach to the small intestine | Obstruction | NA | Endoscopy followed by laparotomy |
| 43 | Deevaguntla et al42 | 12/F | Abdominal pain, vomiting | Stomach to the distal small bowel | No detail available | NA | No detail available |
| 44 | Eryilmaz et al43 | 19/F | Abdominal pain, nausea, vomiting | Stomach to the small intestine | Ulcers, recurrent episodes | Depressive disorder | Laparotomy |
| 45 | Koushk Jalali et al44 | 17/F | Abdominal pain, vomiting, anorexia | Stomach, duodenum | Pancreatitis, weight loss | NA | Laparotomy |
| 46 | Chauhan et al45 | 19/F | Abdominal pain, vomiting, constipation, anorexia | Stomach, ileum | Weight loss | NA | Laparotomy |
| 47 | Flaherty et al46 | 15/F | Nausea, vomiting, early satiety | Oesophagus, stomach, duodenum | Intestinal obstruction | NA | Laparotomy |
| 48 | Sharma et al47 | 12/F | Vomiting, haematemesis, pallor | Stomach, duodenum | Stomach ulcer, anaemia, weight loss | NA | Laparotomy |
| 49 | Beristain-Silva et al48 | 10/F | Abdominal pain, nausea, vomiting | Stomach, small intestine | Weight loss, anaemia | Depression, anxiety | Laparotomy |
| 50 | Dixit et al49 | 20/F | Abdominal pain, abdominal lump, vomiting, anorexia | Stomach to jejunum | Chronic obstruction | Adjustment disorder | Laparotomy |
| 51 | Czerwińska et al50 | 16/F | Symptoms of ileus, epigastric mass | Stomach, duodenum, jejunum | NA | NA | Laparotomy |
| 52 | Athanasiou et al51 | 15/F | Abdominal pain, vomiting, appetite loss | Stomach, duodenum, jejunum | Anaemia, gastric ulcer, weight loss | NA | Laparotomy |
| 53 | George et al52 | 28/F | Epigastric pain, vomiting | Stomach, jejunum | Obstruction | NA | Laparotomy |
| 54 | Andrade et al53 | 27/F | Abdominal pain, nausea, vomiting | Stomach, duodenum | Obstruction | NA | Laparotomy |
| 55 | Prasanna et al54 | 16/F | Abdominal pain, abdominal mass, vomiting | Stomach, duodenum, jejunum, ileum | Intussusception, anaemia | NA | Laparotomy |
| 56 | Kim and Nam55 | 8/F | Abdominal pain, abdominal mass, vomiting | Stomach to the jejunum | Obstruction | NA | Laparotomy |
| 57 | Dogra et al56 | 8/F | Abdominal pain, nausea, vomiting, constipation | Stomach, duodenum | Appendicitis, anaemia, weight loss | NA | Laparotomy |
| 58 | Dogra et al57 | 24/F | Abdominal pain, vomiting, constipation | Stomach jejunum | Anaemia | NA | Laparotomy |
| 59 | Singh et al58 | 5/F | Abdominal pain, vomiting, constipation | Stomach to ileum | Ileal perforation, anaemia, bleeding per rectum | NA | Laparotomy |
| 60 | Lopes et al59 | 22/F | Abdominal pain, vomiting | Stomach, duodenum, jejunum | Intussusception | NA | Laparotomy |
| 61 | Tayyem et al60 | 23/F | Abdominal pain, vomiting, haematemesis, constipation | Stomach, duodenum | Anaemia, peritonitis(perforated gastric ulcer) | NA | Laparotomy |
| 62 | Gonuguntla and Joshi61 | 5/F | Abdominal pain, vomiting, early satiety, decrease appetite | Stomach, small gut | Obstruction | NA | Laparotomy |
| 63 | Dindyal et al62 | 55/M | Abdominal pain, fever, nausea, constipation | Stomach, duodenum | Intestinal obstruction, perforation | Schizophrenia | Laparotomy |
| 64 | Emre et al63 | 18/M | Abdominal pain, nausea, vomiting | Stomach, small gut | Gastric ulcer | Mental retardation | Laparotomy |
| 65 | Rabie et al64 | 11/F | Abdominal mass, epigastric pain, vomiting | Stomach, jejunum | Gastric ulcer. | NA | Laparotomy |
| 66 | Rabie et al64 | 19/F | Abdominal pain, vomiting, constipation, abdominal distension | Stomach to the jejunum | Jejunal intussusception, jejunal perforation | Adjustment disorder | Laparotomy |
| 67 | Tamini et al65 | 46/F | Abdominal pain, vomiting, nausea | Stomach | Intestinal obstruction Weight loss |
Psychosis | Laparotomy |
| 68 | Mnari et al66 | 7/F | Abdominal pain | Stomach to the jejunum | Intussusception, anaemia | NA | Laparotomy |
| 69 | Parakh et al67 | 18/F | Abdominal pain | Stomach, small gut | Gastric perforation | NA | Laparotomy |
| 70 | Marwah et al68 | Young female | Abdominal pain, vomiting | Stomach, duodenum, jejunum | Jejunal intussusception | NA | Laparotomy |
| 71 | Meier and Furtwaengler69 | 7/F | Abdominal pain, abdominal mass, loose stools | Stomach, ileum | Obstruction | NA | Laparotomy |
| 72 | Umbetalina et al70 | 20/F | Vomiting, abdominal pain | Stomach, duodenum, jejunum | Nephrotic syndrome, hypercholesterolaemia, partial obstruction | NA | Laparotomy |
| 73 | Middleton et al71 | 2.5/F | Abdominal pain, vomiting | Stomach to the small intestine | Intussusception | NA | Laparoscopy followed by laparotomy |
| 74 | Kohler et al72 | 9/M | Abdominal pain, vomiting, nausea | Stomach to the ileum | Pancreatitis, jejunal perforation, Intussusception | NA | Laparotomy |
| 75 | Aulagne et al73 | 2.8/F | Nausea, vomiting, abdominal mass, anorexia | Stomach, duodenum, jejunum | Anaemia, weight loss | NA | Laparotomy |
| 76 | Henry et al74 | 10/F | Epigastric pain, vomiting, constipation | Stomach to ileocecal region | Anaemia, obstruction, weight loss | Pica | Laparotomy |
| 77 | Mohite et al75 | 28/F | Abdominal pain, distension | Stomach, duodenum, jejunum | Gastric perforation, peritonitis | Depression | Laparotomy |
| 78 | Koç et al76 | 14/F | Abdominal pain | Stomach, duodenum | Gastric perforation, weight loss | NA | Laparotomy |
| 79 | Anzieta et al77 | 16/F | Vomiting, abdominal pain, | Stomach to the jejunum | Obstruction | Personality disorder | Laparotomy |
| 80 | Salem et al78 | 22/F | Epigastric pain, vomiting | stomach, duodenum | Pancreatitis, gangrene of duodenal jejunal junction | NA | Laparotomy |
| 81 | Kibria et al79 | 6/F | Abdominal pain, constipation | Stomach, duodenum | Intussusception, weight loss | Trichophagia | Laparotomy |
| 82 | Matějů et al80 | 3.10/F | LOC | Stomach to the jejunum | Weight loss, death | Child neglect | Autopsy |
| 83 | Cook et al81 | 12/F | Vomiting, abdominal pain | Stomach to the jejunum | Weight loss, intussusception | NA | Laparotomy |
| 84 | Raikar et al82 | 12/F | Abdominal pain, vomiting | Stomach, duodenum | Obstruction | Depression | Laparotomy |
| 85 | Chogle et al83 | 3/F | Vomiting, jaundice, fever abdominal pain | Stomach, duodenum | Cholestasis, weight loss | NA | Laparotomy |
| 86 | Dorn et al84 | 17/F | Epigastric pain | Stomach, duodenum | Weight loss | Non-specific anxiety disorder | Laparoscopy |
| 87 | Hoover et al85 | 9/F | Abdominal pain, vomiting, abdominal mass | Stomach, small intestine | Obstruction | NA | Laparoscopy followed by laparotomy |
| 88 | Alsafwah and Alzein86 | 29/F | Abdominal pain, tenderness, nausea, vomiting | Stomach, duodenum | Intestinal obstruction | NA | Endoscopy, laparotomy |
| 89 | This case | 38/F | Nausea, vomiting, constipation | Stomach, duodenum and ileum | Hypoproteinaemia, abdominal distension | NA | Laparotomy |