Introduction:

Rapunzel syndrome is a rare entity that consists of a gastric trichobezoar with extension to the duodenum and accompanied by symptoms of intestinal occlusion, increasing the risk of complications such as perforation and peritonitis.

Case report:

A 15-year-old female with a clinical of abdominal pain of two weeks of evolution, associated with nausea, emesis, early satiety and a decrease in the consistency of the stools. It refers to trichotillomania and trichophagia habits of one year of evolution. On physical examination, distended abdomen with decreased peristalsis and no evidence of peritoneal irritation. Imaging studies show an occupational mass in the stomach and first portion of the duodenum, as well as hydro-aerial levels. Surgical management was performed by laparotomy, finding a gastric trichobezoar in addition to another one in the jejunum, performing the complete extraction through gastrotomy and enterotomy. Enteral diet started at 72 hrs. And is a graduate of the service on the seventh day of the postoperative period.

Conclusion:

Bezoars can be resolved by non-surgical methods; however, the patient’s hemodynamic status should be assessed; surgical management is recommended with good results. Multidisciplinary management with this type of patients is necessary to prevent recurrence.