Rapunzel Syndrome Revealed by an Umbilical Hernia: A Case Report and Review of the Literature

Yattara A^1*, Bangoura MS¹, Camara FL^2*, Diop A³, Camara NLY¹, Ibrahima KA³, Diop PS³, Dieng M^4
1Department of General Surgery, Ignace Deen National Hospital, CHU Conakry, Guinea.
²General Surgery Department, Donka National Hospital, Conakry University Hospital, Guinea.
³Department of General Surgery, Idrissa Pouye General Hospital, Dakar, Senegal.
⁴Faculty of Medicine, Pharmacy and Odontology, Cheikh Anta Diop University, Dakar, Senegal.

Correspondence to: Abdoulaye Yattara, Department of General Surgery, Hôpital national Ignace Deen, CHU de Conakry, Guinea. E-mail: yattarakine@gmail.com
Camara FL, General Surgery Department, Donka National Hospital, Conakry University Hospital, Guinea. Email: flcamara37@gmail.com

Received date: April 27, 2025; Accepted date: May 12, 2025; Published date: May 19, 2025
Citation: Yattara A, Bangoura MS, Camara FL, et al. Rapunzel Syndrome Revealed by an Umbilical Hernia: A Case Report and Review of the Literature Rapunzel Syndrome Revealed by an Umbilical Hernia: A Case Report and Review of the Literature J Med Res Surg. 2025;6(3):46-48. doi: 10.52916/jmrs254167
Copyright: ©2025 Yattara A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction: Rapunzel syndrome is a rare entity defined by the presence of a trichobezoar that can sit throughout the digestive tract. It results in psychiatric disorders, trichotillomania and trichophagia. Hernial strangulation is an exceptional mode of revelation of this pathology.
We report a case of Rapunzel syndrome revealed by a recurrent strangulated umbilical hernia.
Case report: This was a 22-year-old female patient with a history of umbilical hernia repair 6 months ago, admitted to the emergency department of Idrissa Pouye General Hospital for painful umbilical swelling. Examination on admission revealed a strangulated umbilical hernia with firm contents and an inferior umbilical scar. Biological work-up was unremarkable. Surgical exploration via an inferior umbilical approach revealed a strangulated umbilical hernia with a 3 cm neck, containing a viable small intestine, and the presence of a 50 cm long inert foreign body in the terminal ileum, enclosed at the ileocaecal angle. We performed a 1 cm enterotomy to extract the foreign body, which was made into a trichobezoar, then closed the enterotomy, treated the sac and cured the hernia using aponeurography. Postoperative recovery was straightforward. She was discharged on the third postoperative day. She was referred to the psychiatric ward for psychiatric and psychological follow-up.
Conclusion: Rapunzel syndrome is a rare condition. Its mode of revelation by a strangulated umbilical hernia is very rare, even exceptional. The evolution can be marked by serious mechanical complications such as intestinal occlusion.

Keywords:

Rapunzel syndrome, Strangulated umbilical hernia, Surgery, Trichobezoar, Pseudo-occlusive syndrome.

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