A case of Rapunzel syndrome

Trichobezoars are concretions of hair casts in the stomach associated with trichotillomania and trichophagia. The condition is termed Rapunzel syndrome when formation of a huge trichobezoar extends to the small bowel, resulting in gastrointestinal obstruction. We present a 19-year-old girl who had complaints of colicky abdominal pain, nausea and vomiting seven years after surgical treatment for a gastric trichobezoar. Gastric endoscopy was performed with an initial diagnosis of recurrent trichobezoar, which revealed a huge one. The patient underwent laparotomy, during which a huge trichobezoar with a long tail was totally removed by an anterior gastrotomy. Following removal of the lesion, the antrum was observed with multiple ulcers secondary to extensive pressure. Postoperative period was uneventful. A subsequent psychiatric consultation revealed depressive personality disorder.