A Case Report of Rapunzel Syndrome in 14-Year-Old Girl

Trichobezoar or hairball in the proximal part of the gastrointestinal tract is a rare condition that occurs mainly in young and adolescent females. Since human hair is resistant to digestive enzymes and resistant to peristalsis, it easily accumulates between the folds of the mucosa. Over time, food and mucus accumulate within the hair, forming a compact mass that fills almost the entire lumen. When a trichobezoar passes through the pylorus and reaches the duodenum, and in some cases even the jejunum, it is referred to as Rapunzel syndrome. The treatment is surgical. Depending on the location and size of the trichobezoar, it can be removed endoscopically, laparoscopically, or by conventional laparotomy. Our report aims to present the surgical treatment of Rapunzel syndrome, as part of a comprehensive approach to this disease. We present a 14-year-old girl who was diagnosed and treated in our department. According to the world practice and our experience, conventional laparotomy as a method of treatment remains the first choice. The smaller gastrointestinal trichobezoars are asymptomatic or with unusual clinical manifestations. They grow undetected and combined with mental disorders can lead to significant gastrointestinal complications such as mainly intestinal obstruction and rarely erosions, ulcers, and perforation. The treatment is multimodal including surgeons, pediatricians, and psychiatrists.