The Rapunzel Syndrome in a Four-year-old Girl

Trichobezoar is a rare pathology in which swallowed hair accumulates in the stomach. An unusual form of bezoar extending from the stomach to the small intestine or beyond is described as Rapunzel syndrome (RS). Trichobezoars typically cause abdominal pain and nausea, but can also present as an asymptomatic abdominal mass, progressing to abdominal obstruction and perforation. Trichobezoar with RS is an uncommon diagnosis. It is predominantly found in emotionally disturbed or mentally retarded young people. The diagnosis may be suspected in young females with abdominal pain, epigastric mass, and malnutrition, who have a history of trichophagia. We present a case of successful laparotomy removal of a gastro-duodenal trichobezoar in a 4-year-old girl with a history of trichotillophagia. The psychodynamic aspects, clinical manifestations, diagnoses, and therapeutic strategies are discussed. © 2022 by the Turkish Association for child and Adolescent Psychiatry / Turkish Journal of Child and Adolescent Mental Health. published by Galenos Publishing House.