Trichobezoar-associated jejunojejunal intussusception: an exceptionally rare manifestation of Rapunzel syndrome

Rapunzel syndrome, a rare type of trichobezoar where a hairball in the stomach extends into the small intestine through the pylorus. Intussusception associated with Rapunzel syndrome is particularly rare, with fewer than 10 reported cases worldwide. This report presents a 20-year-old woman with jejunojejunal intussusception caused by Rapunzel syndrome. She had 3 months of upper abdominal pain, vomiting, early fullness, weakness, and noticeable abdominal mass. Contrast-enhanced computed tomography scan revealed a trichobezoar with jejunal extension, causing transient jejunojejunal intussusception. Exploratory laparotomy confirmed the diagnosis of Rapunzel syndrome, and the trichobezoar was removed via gastrotomy. Following extraction, the intussusception resolved spontaneously. The patient was discharged on postoperative Day 7 after an uneventful recovery. Psychiatric evaluation later identified trichotillomania, and behavioural therapy was initiated, with no recurrence. The rare association between trichobezoar and jejunojejunal intussusception underscores the need for prompt diagnosis, definitive surgical management, and psychiatric assessment to minimize the risk of recurrence.