Published: 2019-11-26

Unusual trichobezor of stomach and intestines as a manifestation of Rapunzel syndrome: a rare case report

Tejinder Pal Singh Sodhi, Sameer Pundeer, Maneshwar Singh Utaal, Kirti Savyasacchi Goyal


Rapunzel syndrome is a rare form of trichobezoar with accumulation of large amounts of hair extending from stomach to variable portion of small intestine. An 18 year old girl was brought to surgery opd with complaints of vomiting on and off since 3 months. Contrast enhanced computed tomography abdomen showed a bezoar extending from stomach into the duodenum and proximal jejunum suggestive of Rapunzel syndrome with 3rd and 4th part of duodenum along with duodenojejunal junction. On laparotomy, a trichobezoar occupying the entire stomach measured 100 cm in length and 700 grams in weight. Since the mass formed in Rapunzel syndrome is generally too large to be removed endoscopically or laparoscopically, it requires removal by open gastrostomy. 


Rapunzel syndrome, Trichobezoar, Duodenojejunal junction

Full Text:



Grimm Brothers: Rapunzel. Translated by Richmond GR. Virginia Commonwealth University, Department of Foreign Languages; 1994-1999.

Rabie ME, Arishi AR, Khan A, Ageely H, Seif El-Nasr GA, Fagihi M. Rapunzel syndrome: the unsuspected culprit. World J Gastroenterol. 2008;14:1141-3.

Gonuguntla V, Joshi DD. Rapunzel syndrome: a comprehensive review of an unusual case of trichobezoar. Clin Med Res.2009;7(3):99-102.

Birmingham CL, Gritzner S. Gastric bezoar in anorexia nervosa. Eat Weight Disord. 2007;12:e28-9.

Bouwer C, Stein DJ. Trichobezoars in trichotillomania: case report and literature overview. Psychosom Med. 1998;60:658-60.

Walsh KH, Mcdougle CJ. Trichotillomania. Presentation, etiology, diagnosis, and therapy. Am J Clin Dermatol. 2001;2:327-333.

Narci A, Sen TA. Treatment of Rapunzel syndrome gastrostomy or gastrostomy?. Dig Surg. 2008;25:80.