Sindrome de Rapunzel

Abstract

Rapunzel syndrome is a fairly unusual cause of intestinal obstruction. We report the case of a 36-yearold woman with symptoms of diffuse abdominal pain, nausea, vomiting, early satiety and weight loss in the last 3 months. Clinical examination reveals a pale, malnourished woman with a mobile abdominal mass of hard consistency, painful to palpation, which occupies epigastrium and mesogastrium. A computerized abdominal tomography showed a heterogeneous mass occupying the whole cavity of the stomach with extension to the second portion of the duodenum. A diagnosis of giant trichobezoar is suspected after further interrogation that reveals trichophagia, emotional disorders and depressive episodes. Exploratory laparotomy was decided.
Antral gastrotomy was performed and a trichobezoar
of 40x15x7 cm was extracted. The patient had an
uneventful postoperative recovery, being discharged
on the fifth day.