Ileal Trichobezoar Causing Small-Bowel Obstruction in a Case of Rapunzel Syndrome

Trichobezoars are uncommon masses found in the stomach, formed from ingested hair. They are most often observed in young females with underlying psychiatric disorders like trichotillomania and trichophagia. While trichobezoars typically remain confined to the stomach, they can occasionally extend into the small intestine, causing obstruction?a condition known as Rapunzel syndrome1. We report the case of a young female patient who presented with symptoms of acute intestinal obstruction, including abdominal pain, vomiting, and constipation. Imaging studies revealed an intraluminal mass extending from the stomach into the small bowel2. Surgical exploration confirmed the presence of a large trichobezoar causing mechanical obstruction. The mass was successfully removed via enterotomy and gastrotomy. Postoperatively, the patient recovered well and was referred for psychiatric evaluation and counseling. This case highlights the importance of considering trichobezoar in the differential diagnosis of young females presenting with signs of gastrointestinal obstruction, especially when accompanied by a suggestive behavioral history.