Published: 2020-04-23

Trichobezoars: a hairy cause of intestinal obstruction

Anurag Tiwary, Pragati Singhal, Nida Khan, Pramod Tiwary


Trichobezoars are an infrequent form of bezoar found in the stomach or intestine, created from ingested hair. Their most frequent location is in the stomach but they may extend through the pylorus into the small bowel. This condition is known as Rapunzel syndrome. Trichobezoar with Rapunzel syndrome is an uncommon diagnosis in children. Authors report 3 cases of Rapunzel syndrome with a large bezoar in paediatric age group that presented with features of acute intestinal obstruction. They were managed with surgical exploration.


Bezoar, Rapunzel, Trichobezoar, Trichophagy

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Duke DC, Keeley ML, Geffken GR, Storch EA: Trichotillomania: a current review. Clin Psychol Rev. 2010;30(2):181-93.

Coulter R, Antony MT, Bhuta P, Memon MA. Large gastric trichobezoar in a normal healthy woman: case report and review of pertinent literature. South Med J. 2005;98(10):1042-4.

DeBakey M, Ochsner A. Bezoars and concretions: a comprehensive review of the literature with an analysis of 303 collected cases and a presentation of 8 additional cases. Surgery. 1938 Dec 1;4(6):934-63.

Grimm Brothers: Rapunzel. Translated by Godwin-Jones R. Richmond, Virginia Commonwealth University Department of Foreign Languages, 1994-1999.

Naik S, Gupta V, Naik S, Rangole A, Chaudhary AK, Jain P, Sharma AK. Rapunzel syndrome reviewed and redefined. Digest Surg. 2007;24(3):157-61.

O'sullivan MJ, McGreal G, Walsh JG, Redmond HP. Trichobezoar. J Royal Soci Medi. 2001 Feb;94(2):68-70.

Gorter RR, Kneepkens CM, Mattens EC, Aronson DC, Heij HA. Management of trichobezoar: case report and literature review. Pediatr Surg Int. 2010 May 1;26(5):457-63.

Rattan KN, Yadav V, Yadav V, Singh J. Ileal Trichobezoar Presenting as Intestinal Obstruction and Peritonitis. APSP J Case Rep. 2017 Mar 21;8(2):11.

Goyal V, Goyal PK, GuPta M. A rare case of small bowel obstruction due to primary trichobezoar. J Clini Diagnost Res: JCDR. 2014 Mar;8(3):168.

Jensen AR, Trankiem CT, Lebovitch S, Grewal H. Gastric outlet obstruction secondary to a large trichobezoar. J Pediatr Surg. 2005 Aug 1;40(8):1364-5.

Tudor EC, Clark MC. Laparoscopic-assisted removal of gastric trichobezoar; a novel technique to reduce operative complications and time. J Pediatr Surg. 2013 Mar 1;48(3):e13-5.