Atypical Rapunzel Syndrome in an Adult Female: Trichobezoar Beyond the Gastric Outlet Leading to Gastrointestinal Perforation and Septic Shock.

Abstract

Trichobezoars are rare accumulations of ingested hair typically seen in young females with psychiatric disorders such as trichotillomania and trichophagia. Few case reports describe separate trichobezoar masses within the GI tract. We report the case of a 57-year-old female with trichophagia history who presented with abdominal distensions and rebound tenderness consistent with peritonitis. Imaging raised suspicion for bezoars, and emergent laparotomy revealed two separate trichobezoars, one in the gastric antrum and one in the jejunum, as well as two jejunal perforations. This case highlights that trichobezoars can present in an atypical demographic and extend beyond the gastric outlet, potentially resulting in life-threatening complications requiring prompt surgical management.