Rapunzel syndrome

Rapunzel syndrome is a variant of trichobezoar of the stomach where the tail of the bezoar extends into the ileum for a variable distance. This syndrome has been reported in fewer than 30 patients worldwide. It is predominantly seen in women; mean age of presentation is around 11 years. Symptoms include abdominal pain, nausea, vomiting, weight loss, cachexia and signs of obstruction. A palpable epigastric mass should raise the suspicion. If hair thinning is noticed, the diagnosis is strongly suspected and can be confirmed on computed tomography or gastroscopy. Treatment of this is surgical removal by gastrotomy, with or without the need for enterotomy.