SiSaid Meliani, K. Meliani, M. Kouadri, O. Ayouche, N. Bouknani, S. Berrada, A. Rami
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 2
Date of Publication: 2026/02/07
Trichobezoars are concretions of ingested hair that accumulate within the gastrointestinal tract, most commonly in the stomach. They are predominantly observed in young females with trichophagia, often in the context of underlying psychiatric disorders. Small bowel obstruction caused by a trichobezoar is a rare but potentially serious complication. The Rapunzel syndrome, characterized by a gastric trichobezoar with a tail extending through the pylorus into the small intestine, is an even rarer variant. We report the case of an 8-year-old girl who presented with acute abdominal pain and signs of intestinal obstruction. Ultrasound demonstrated an arciform hyperechoic line with complete posterior acoustic shadowing in the left iliac fossa, suggestive of a bezoar. Contrast-enhanced CT confirmed the diagnosis by revealing small bowel distension and a well-defined, heterogeneous, intraluminal mass in the distal ileum with entrapped air, characteristic of a trichobezoar causing mechanical obstruction. Surgical exploration confirmed a large trichobezoar with a gastric body and an ileal tail consistent with Rapunzel syndrome. This case illustrates the key imaging features of trichobezoar-related intestinal obstruction and emphasizes the role of CT in establishing the diagnosis and guiding surgical management.
Trichobezoar; Rapunzel syndrome; Small bowel obstruction; Pediatric; Computed tomography; Ultrasound; Trichophagia
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