Fatal case of Rapunzel syndrome in neglected child

Received 19 November 2008; received in revised form 11 May 2009; accepted 12 May 2009. published online 08 June 2009.

Abstract

Rapunzel syndrome is very extreme form of trichobezoar formation where the tail of the trichobezoar extends from the stomach into the small intestine. Death resulting from this condition is rare and is usually associated with gastric or intestinal perforation. We report a fatal case of Rapunzel syndrome in a 3 years and 10 months old girl. Review of the literature indicates that this case involves the youngest child to have died from this syndrome. Furthermore, this case is unique due to the clear association with the parent's neglect with failure to provide the child with adequate health care.

Keywords: Rapunzel syndrome, Child neglect, Trichobezoar, Bezoar, Fatal outcome

a Institute of Forensic Medicine, St. Anne's University Hospital, Tvrdého 2a, 60200 Brno, Czech Republic

b Institute of Forensic Medicine, Faculty of Medicine, Comenius University, Sasinkova 4, 811 08 Bratislava, Slovakia

c forensic.sk Inštitút forenzných medicínskych expertíz s.r.o. Boženy Němcovej 8, 811 04 Bratislava, Slovakia

d Department of Criminal Law and Criminology, Faculty of Law, Trnava University, Hornopotočná 23, 917 48 Trnava, Slovakia

e Macomb County Medical Examiner Department, 43585 Elizabeth Rd Mt. Clemens, MI 48043, USA

f Department of Pathology, Wayne State University School of Medicine, Detroit, MI 48201, USA

Corresponding author at: forensic.sk Inštitút forenzných medicínskych expertíz s.r.o. , Boženy Němcovej 8, 811 04 Bratislava, Slovakia. Tel.: +421 905 941 183.

PII: S0379-0738(09)00212-6

doi:10.1016/j.forsciint.2009.05.008

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