ArticleCureus2026
Rapunzel Syndrome Complicated by Cholecystoduodenal Fistula Secondary to Biliary Compression: A Case Report of a Patient With Cerebral Palsy.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Rapunzel syndrome is a rare form of gastric trichobezoar that extends into the small intestine, leading to intestinal obstruction. Biliary-enteric fistulas are abnormal communications between the biliary system and the gastrointestinal tract, generally occurring spontaneously. We report the case of a 26-year-old female patient with a history of cerebral palsy who presented to the emergency department with an acute abdomen. Computed tomography revealed a mass occupying the stomach and intestine. A laparotomy was performed, identifying a gastric and duodenal trichobezoar complicated by an acute perforated gastric ulcer, in addition to a vesicoduodenal fistula secondary to extrinsic compression of the gallbladder. This fistula clinically mimicked a type V Mirizzi syndrome. A Roux-en-Y hepaticojejunostomy was carried out. The patient died from nosocomial pneumonia 30 days later. This case highlights the importance of a multidisciplinary approach in patients with underlying neurological conditions and underscores the surgical feasibility of hepaticojejunostomy in complex scenarios of secondary biliary involvement.
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