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

E Kouskos; D Polychroni; M Rizou; A Andronikou; V Petrellis

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

Hippokratia. 2023 Jan-Mar;27(1):25-27.

Authors

E Kouskos¹, D Polychroni², M Rizou¹, A Andronikou¹, V Petrellis³

Affiliations

¹ Surgical Department, General Hospital of Mytilene, Lesvos Island, Greece.
² Department of Obstetrics and Gynecology, General Hospital of Mytilene, Lesvos Island, Greece.
³ Department of Radiology, General Hospital of Mytilene, Lesvos Island, Greece.

PMID: 38533225
PMCID: PMC10908309

Abstract

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

Case description: 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.

Conclusion: 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.

Keywords: Rapunzel syndrome; Trichobezoar; trichophagia; trichotillomania.

Publication types

Case Reports