Intestinal Subocclusion Due to Rapunzel Syndrome in a Female with Cerebral Palsy

Abstract

Rapunzel syndrome is a rare variant of trichobezoar characterized by a hair mass extending from the stomach into the duodenum. Management depends on the severity of clinical presentation and the bezoar's size and location, with surgery often being the preferred approach. This condition predominantly affects adolescent females with psychiatric disorders or neurodevelopmental delays, particularly those exhibiting trichotillomania and trichophagia. We report the case of a 19-year-old female with cerebral palsy who presented with nonspecific diffuse abdominal pain, nausea, vomiting, and episodes of constipation. Imaging studies, including ultrasound and computed tomography, suggested the presence of a trichobezoar.

Clinicians should maintain a high index of suspicion for trichobezoar in adolescents with signs of partial or complete intestinal obstruction, especially when associated with psychiatric comorbidities and a known history of hair-pulling behaviors.