Gastric trichobezoar and Rapunzel syndrome: case report of a very rare condition

Rapunzel syndrome is a rare trichobezoar variant extending from the gastric cavity into the small bowel.

We report the case of a 22-year-old woman who presented with epigastric pain, nausea, and loss of appetite within the preceding five weeks. She had a palpable mass in the epigastric area with mild localized tenderness. Her abdominal computed tomography scan showed a distended stomach and duodenum, with a heterogeneous solid material, suspicious for a bezoar. Upper gastrointestinal endoscopy revealed a large, densely packed trichobezoar occupying the gastric cavity and extending through the pylorus. Endoscopic removal of the bezoar was unsuccessful. The patient underwent a 6cm-long gastrotomy, and the 150cm-long bezoar, extending from the stomach to the jejunum, was uneventfully removed. The patient was referred postoperatively to a dietitian and psychiatrist for management of her trichotillomania and trichophagia.

Trichobezoars are commonly found in young females with a history of trichotillomania and trichophagia and are associated with psychiatric disorders. HIPPOKRATIA 2023, 27 (1):25-27.