Non-obstructive Giant Gastric Trichobezoar: A case of Rapunzel Syndrome

Abstract

ABSTRACT. Even in one case, the patient was pulling his dog's hairs and eating them 1,2 . In this report we aimed to present a non-obstructive giant trichobezoar without weight loss. Case ReportA 17 year-old female patient was admitted to surgical outpatient clinic for abdominal pain and stress. Th e patient's body mass index (BMI) was 28 and her nutritional status was normal.Physical examination revealed a good general condition with normal vital signs. During the abdominal examination we observed a painless mass in the left upper quadrant. Th e rest of the physical examination was unremarkable.Biochemical tests and complete blood count were normal. Ultrasound and computed tomography examinations revealed a space occupying lesion that could possibly be trichobezoar (Figure 1). Th us we performed an upper gastrointestinal endoscopic exploration and found out a trichobezoar fi lling the stomach and extending into the duodenum.We could not fragment the bezaor and thus, had to perform surgical exploration. Th e patient was operated by a midline incision. During the surgical process we observed that the stomach was elongated and pithotic ( Figure 2). We also palpated the gastric bezoar and demonstrated that it was extending in to the duodenum. Th e bezoar was pulled out from the gastrotomy incision made on the anterior wall of stomach. Gastrotomy was closed by two layers running absorbable suture (Figures 3, 4).