Abstract

ORDONEZ, Arlin; SANCHEZ-SIERRA, Luis  and  MEJIA ESCOBAR, Cinthya. Rapunzel syndrome: cause of intestinal subobstruction in a teenager. Case report. Acta méd. costarric [online]. 2025, vol.67, n.2, pp.93-97. ISSN 0001-6002.  http://dx.doi.org/10.51481/amc.v67i2.1474.

Introduction: Rapunzel Syndrome is a rare type of trichobezoar caused by trichophagia, often associated with trichotillomania. Trichobezoars are masses composed of ingested hair, most commonly located in the stomach, and may extend into the small intestine through the pylorus in RS cases. We present the case of an adolescent diagnosed with Rapunzel Syndrome and a psychiatric history. A 14-year-old female with a history of anxiety, depression, trichotillomania, and trichophagia presented with chronic abdominal pain, postprandial nausea and vomiting, hyporexia, and significant weight loss. On physical examination, a painful epigastric mass was palpated. Abdominal computed tomography revealed an intraluminal mass extending from the stomach to the duodenum. Upper gastrointestinal endoscopy confirmed a trichobezoar. Exploratory laparotomy and surgical extraction of a 36 cm mass were performed. The patient had a favorable postoperative course and received multidisciplinary follow-up. Conclusion: Rapunzel Syndrome should be suspected in patients with nonspecific gastrointestinal symptoms and a psychiatric history. Surgical treatment, combined with psychiatric and multidisciplinary care, is essential to prevent complications and recurrence. Early diagnosis is crucial for improving prognosis.

Keywords : Syndrome; trichotillomania; anxiety; hair; bezoars.

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