Rapunzel syndrome - a giant gastric trichobezoar extending to proximal jejunum in a young adult female: A case report

Ksenija Mijović ^1* Dragan Vasin ^1,2 Sanela Hasanagić ¹ Jelica Vukmirović ¹ Tijana Tomic ¹ Vasko Tošić ³ Aleksandar Pavlović ¹ Dragan Mašulović ^1,2 Aleksandra Đurić Stefanović ^1,2,4

• ¹ Center for Radiology, University Clinical Center of Serbia, Belgrade, Serbia
• ² Faculty of Medicine, University of Belgrade, Belgrade, Serbia
• ³ Emergency Surgery Clinic, University clinical Center of Serbia, Belgrade, Serbia
• ⁴ Department of Digestive Radiology, First Surgery Clinic, University Clinical Center of Serbia, Belgrade, Serbia

A trichobezoar is an intraluminal mass of hair growing continuously with its additional ingestion, while a Rapunzel syndrome represents a giant gastric trichobezoar extending beyond the stomach into the small intestine. We present a case of Rapunzel syndrome as an unusual cause of upper gastrointestinal symptoms in a young adult female denying trichotillomania and trichophagia. Preoperative radiological assessment was pivotal in planning a preferable therapeutic approach. The patient was treated by laparotomy and prepyloric gastrotomy with satisfying postoperative results.Trichobezoars are exceedingly rare and mostly occur in young females with underlying psychiatric conditions. Although uncommon, they cause severe upper gastrointestinal symptoms and can even lead to various complications. Our aim is to help to understand the presentation of gastric trichobezoar and Rapunzel syndrome and its range of symptoms, as well as its radiological appearance and associated findings, in order to make an accurate diagnosis which leads to adequate treatment approach.