Pediatric Rapunzel Syndrome Presenting With Jejunojejunal Intussusception Managed Surgically: A Rare Case Report

Bezoars are masses of indigestible material within the gastrointestinal tract. Trichobezoars, composed of hair, are rare and typically occur in young females with psychiatric conditions. Rapunzel syndrome is a severe variant where the trichobezoar extends into the small intestine. We report a case of a 7-year-old girl presenting with acute abdominal pain, reduced appetite, and a palpable epigastric mass. She had a history of trichophagia and weight loss. Investigations revealed microcytic hypochromic anemia and a large intragastric mass extending into the duodenum, with associated jejunojejunal intussusception on CT scan. She underwent laparotomy with gastrotomy, and a 15 × 7 cm trichobezoar was removed. Intraoperatively, the intussusception had spontaneously reduced, and the small bowel was viable with no resection required. Postoperative recovery was complicated by wound infection. Psychiatric assessment confirmed trichotillomania and trichophagia. This case emphasizes the importance of early recognition of Rapunzel syndrome in children with behavioral symptoms and abdominal complaints. Surgical removal remains the definitive treatment, and psychiatric follow-up is crucial to prevent morbidity and recurrence. Prompt diagnosis, timely surgical management, and structured psychiatric follow-up are essential to prevent recurrence and morbidity.