Unusual Presentation of Rapunzel Syndrome in an 8-Year-Old Girl

Trichobezoar is a rare clinical entity in which a ball of hair accumulates within the alimentary tract. It can be found as an isolated mass in the stomach or may extend into the duodenum and jejunum, which is labeled as Rapunzel syndrome. In this article, we report a rare case of Rapunzel syndrome with a long tail that presented with non-specific features. Case Presentation: An 8-year-old female patient was referred to our clinic due to palpable abdominal mass. Physical examination revealed non-tender, well-defined abdominal mass and signs of anemia. Imaging showed a giant bezoar filling the stomach, duodenum, and part of jejunum without features of mechanical obstruction. Laparotomy revealed large trichobezoar with long tail. Retrospective evaluation showed significant hair loss and frequent habit of trichotillomania and trichophagia. Conclusion: Rapunzel Syndrome is not a fairy tale. It may present with vague non-obstructing features. Significant hair loss and underlying psychiatric disorders should raise suspicion to do further investigations. Long-term follow-up and psychiatric management are recommended to prevent recurrence.