Rapunzel syndrome debuts as a gastric perforation

Abstract

Rapunzel syndrome refers to a rare disease that consists of a variant of gastric trichobezoar that has an extension distal to the small bowel. Most cases occur in young women with an underlying psychiatric illness, such as trichotillomania and trichophagia. The trichobezoar should be considered as a differential diagnosis of abdominal pain in young patients with the presence of associated psychiatric pathology since its early diagnosis allows avoiding complications. We present the case of Rapunzel syndrome in a young female patient with no documented history of trichotillomania or trichophagia who presented with gastric perforation. The patient underwent surgery, and a 25 cm trichobezoar was extracted from the stomach. She was discharged home on the 3rd postoperative day. Multidisciplinary management with general surgery, gastroenterology, and psychiatry divisions is essential for offering an integrative treatment to these patients.