The Rapunzel syndrome. Report of a case

Trichobezoar is a rare pathology in which swallowed hairs accumulate in the stomach. An unusual form of bezoar extending from the stomach to the small intestine or beyond has been described as Rapunzel syndrome. Trichobezoars typically cause abdominal pain and nausea, but can also present as an asymptomatic abdominal mass, progressing to abdominal obstruction and perforation. Trichobezoar with Rapunzel syndrome is an uncommon diagnosis. It is predominantly found in emotionally disturbed or mentally retarded young people. The diagnosis may be suspected in young females with abdominal pain, epigastric mass and malnutrition, who have a history of trichophagia. The Authors present a case of successful laparotomy removal of a giant gastro-duodenal trichobezoar in a 9-year-old girl with a history of trichotillophagia. Physical examination revealed diffuse abdominal pain and an epigastric mass. Psychodynamic aspects, clinical manifestations, diagnosis and therapautic strategies are discussed.