Gastric Ascariasis Mimicking Rapunzel Syndrome in an Epileptic Patient: Learning Points Galore

Rapunzel syndrome refers to a very rare condition in which swallowed hair forms a gastric trichobezoar that has a long tail extending into the small bowel. It presents with early satiety, malnutrition, obstructive symptoms, and sometimes, gastric-outlet obstruction. Despite the varied manifestations...

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Main Authors: Paras Passi, Sumita Kanwar, Swati Chaurasiya, Sumit Vats, Ravinder Kumar, Shalini Singh
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2019-01-01
Series:Indian Journal of Medical Specialities
Subjects:
Online Access:https://journals.lww.com/10.4103/INJMS.INJMS_5_18
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author Paras Passi
Sumita Kanwar
Swati Chaurasiya
Sumit Vats
Ravinder Kumar
Shalini Singh
author_facet Paras Passi
Sumita Kanwar
Swati Chaurasiya
Sumit Vats
Ravinder Kumar
Shalini Singh
author_sort Paras Passi
collection DOAJ
description Rapunzel syndrome refers to a very rare condition in which swallowed hair forms a gastric trichobezoar that has a long tail extending into the small bowel. It presents with early satiety, malnutrition, obstructive symptoms, and sometimes, gastric-outlet obstruction. Despite the varied manifestations of Ascaris infestation in man, gastric ascariasis is rare which is demonstrated in the stomach by radiology and by endoscopic examination. We present a rare case of trichobezoar in a 14 years epileptic female with recurrent seizure episodes and no prior history of psychiatric illness or worm infestation where the final diagnosis of gastric ascariasis was made on upper gastrointestinal-endoscopy revealing the presence of worms at the level of the fundus and body of the stomach. Endoscopically some worms were removed, and the rest passed down dead in stools after antihelminthic treatment. Recovery was uneventful and free of complications. Frequent seizures could also be attributed to malabsorption of anti-epileptic drugs because of gastric ascariasis. A prompt diagnosis (tissue diagnosis and direct visualization) always scores above characteristic radiologic findings and appropriate therapy can reduce comorbidities.
format Article
id doaj-art-77dd87e65d154e4f82a2184bcdd20211
institution Kabale University
issn 0976-2884
0976-2892
language English
publishDate 2019-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Indian Journal of Medical Specialities
spelling doaj-art-77dd87e65d154e4f82a2184bcdd202112025-08-25T08:30:49ZengWolters Kluwer Medknow PublicationsIndian Journal of Medical Specialities0976-28840976-28922019-01-01101424410.4103/INJMS.INJMS_5_18Gastric Ascariasis Mimicking Rapunzel Syndrome in an Epileptic Patient: Learning Points GaloreParas PassiSumita KanwarSwati ChaurasiyaSumit VatsRavinder KumarShalini SinghRapunzel syndrome refers to a very rare condition in which swallowed hair forms a gastric trichobezoar that has a long tail extending into the small bowel. It presents with early satiety, malnutrition, obstructive symptoms, and sometimes, gastric-outlet obstruction. Despite the varied manifestations of Ascaris infestation in man, gastric ascariasis is rare which is demonstrated in the stomach by radiology and by endoscopic examination. We present a rare case of trichobezoar in a 14 years epileptic female with recurrent seizure episodes and no prior history of psychiatric illness or worm infestation where the final diagnosis of gastric ascariasis was made on upper gastrointestinal-endoscopy revealing the presence of worms at the level of the fundus and body of the stomach. Endoscopically some worms were removed, and the rest passed down dead in stools after antihelminthic treatment. Recovery was uneventful and free of complications. Frequent seizures could also be attributed to malabsorption of anti-epileptic drugs because of gastric ascariasis. A prompt diagnosis (tissue diagnosis and direct visualization) always scores above characteristic radiologic findings and appropriate therapy can reduce comorbidities.https://journals.lww.com/10.4103/INJMS.INJMS_5_18gastric ascariasisgastric outlet obstructionrapunzel syndrometrichobezoar
spellingShingle Paras Passi
Sumita Kanwar
Swati Chaurasiya
Sumit Vats
Ravinder Kumar
Shalini Singh
Gastric Ascariasis Mimicking Rapunzel Syndrome in an Epileptic Patient: Learning Points Galore
Indian Journal of Medical Specialities
gastric ascariasis
gastric outlet obstruction
rapunzel syndrome
trichobezoar
title Gastric Ascariasis Mimicking Rapunzel Syndrome in an Epileptic Patient: Learning Points Galore
title_full Gastric Ascariasis Mimicking Rapunzel Syndrome in an Epileptic Patient: Learning Points Galore
title_fullStr Gastric Ascariasis Mimicking Rapunzel Syndrome in an Epileptic Patient: Learning Points Galore
title_full_unstemmed Gastric Ascariasis Mimicking Rapunzel Syndrome in an Epileptic Patient: Learning Points Galore
title_short Gastric Ascariasis Mimicking Rapunzel Syndrome in an Epileptic Patient: Learning Points Galore
title_sort gastric ascariasis mimicking rapunzel syndrome in an epileptic patient learning points galore
topic gastric ascariasis
gastric outlet obstruction
rapunzel syndrome
trichobezoar
url https://journals.lww.com/10.4103/INJMS.INJMS_5_18
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AT swatichaurasiya gastricascariasismimickingrapunzelsyndromeinanepilepticpatientlearningpointsgalore
AT sumitvats gastricascariasismimickingrapunzelsyndromeinanepilepticpatientlearningpointsgalore
AT ravinderkumar gastricascariasismimickingrapunzelsyndromeinanepilepticpatientlearningpointsgalore
AT shalinisingh gastricascariasismimickingrapunzelsyndromeinanepilepticpatientlearningpointsgalore