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We present a case of a 7-year-old girl with Rapunzel syndrome, a rare complication of trichobezoar, initially presenting with nonspecific symptoms. Diagnostic challenges led to delayed intervention. Surgical removal of the trichobezoar was successful, but postoperative complications included jejunojejunal intussusception, highlighting the necessity for vigilant follow-up and comprehensive psychiatric evaluation. The emergence of intussusception emphasizes the profound impact of underlying psychiatric disorders, such as trichotillomania and trichophagia, which contribute to trichobezoar formation. These conditions necessitate ongoing psychiatric management to address behavioral factors that predispose to recurrent bezoar formation and associated gastrointestinal complications. Effective follow-up strategies should encompass immediate postoperative care and long-term psychiatric support to optimize patient outcomes and minimize the risk of recurrent intussusception.
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http://dx.doi.org/10.1093/jscr/rjae623 | DOI Listing |
J Surg Case Rep
September 2025
Department of Surgery, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia.
Gastric outlet obstruction (GOO) is an uncommon, yet potentially severe, condition arising from multiple causes, including ingesting foreign bodies. The formation of plastic bezoars or trichobezoars due to swallowing indigestible materials remains a rare cause, especially among children exhibiting pica behavior (Vaughan The Rapunzel syndrome: an unusual complication of intestinal bezoar. 1968;:339-43).
View Article and Find Full Text PDFCureus
August 2025
Radiology, Augusta University Medical College of Georgia, Augusta, USA.
We present a case of Rapunzel syndrome in a nine-year-old girl with nonverbal autism, pica, and trichotillomania, who presented for acute worsening of abdominal pain and vomiting. Imaging revealed a bezoar extending from the stomach through most of the small intestine, resulting in multiple small bowel-small bowel intussusceptions. Open laparotomy confirmed the presence and enabled the removal of gastroenteric trichobezoars.
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July 2025
Bariatric Surgery, Bayhealth Hospital, Dover, USA.
Trichobezoars are rare accumulations of ingested hair typically seen in young females with psychiatric disorders such as trichotillomania and trichophagia. Few case reports describe separate trichobezoar masses within the GI tract. We report the case of a 57-year-old female with trichophagia history who presented with abdominal distensions and rebound tenderness consistent with peritonitis.
View Article and Find Full Text PDFClin Case Rep
August 2025
Pediatric Surgery Department, Fattouma Bourguiba Hospital University of Monastir Monastir Tunisia.
Intussusception is a condition in which one part of the intestine slides into an adjacent part of the intestine. Intussusception is an important cause of an acute abdomen and the second most common cause of bowel obstruction in children. Trichobezoars, which are rare in children and often linked to psychiatric disorders, seldom cause intestinal intussusception.
View Article and Find Full Text PDFInt J Surg Case Rep
September 2025
University of MONASTIR, Faculty of Medicine of Monastir, 5000, Fattouma Bourguiba Hospital, Department of Visceral Surgery, Monastir, Tunisia.
Introduction And Importance: Trichobezoars are typically localized to the stomach but can rarely extend into the small bowel, causing a condition known as Rapunzel syndrome. This rare entity primarily affects young females with psychiatric conditions such as trichotillomania and trichophagia. The recurrent nature of this syndrome and its association with psychological disorders necessitate a multidisciplinary approach.
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