Trichobezoar with Rapunzel syndrome: a case report of a 23-year-old female with trichophagia

Introduction and importance: Trichobezoars (hair concretions) are uncommon and are typically found in young women with psychiatric issues, who often deny eating their own hair (trichophagia). Continuous ingestion over time can cause hair to lodge in the stomach along with mucus and food. In some cases, the trichobezoar can extend past the pylorus into the jejunum, ileum, or even the colon, a condition known as Rapunzel syndrome. Only a few cases have been reported from Sudan. Clinical presentation: We reported a case of Trichobezoar with Rapunzel syndrome in a 23-year-old female with a history of trichophagia, managed by laparotomy and anterior gastrostomy. The post-operative period went smoothly, and the patient was discharged in good condition before being referred to the psychiatric department. Clinical discussion: Diagnosing trichobezoar is difficult, especially in low-resource settings, where it relies on clinical expertise. Surgery is the cornerstone of management; a multidisciplinary approach is important to address the underlying cause. Conclusion: Trichobezoar, although it is a rare medical condition, should not be overlooked as a differential diagnosis in young females presenting with nonspecific upper abdominal complaints and an epigastric mass. Early recognition and multidisciplinary management are essential to prevent complications and recurrence.