Trichobezoar with Gastric Perforation


  • SMS Medical College, Department of General Surgery, Jaipur, India
  • SP Medical College, Department of Urology, Bikaner, India
  • SMS Medical College, Department of Physiology, Jaipur, India
  • Railway Hospital, Jaipur, Jaipur, India


Trichobezoar is a rare disorder in which a collection of swallowed hair and some undigested food particles are retained in the gut. The most common type of bezoar is gastric trichobezoar. It is frequently seen in psychiatric patients (trichotillomania). An unusual form of bezoar extending from the stomach to the small intestine or beyond has been described as Rapunzel syndrome. It may present with vague symptoms, such as anorexia, anemia, weight loss, abdominal mass, recurrent abdominal pain or symptoms and signs of intestinal obstruction. This report illustrates a 19 yrs old female who presented to our emergency department with diffuse peritonitis due to gastric perforation and found to have a huge trichobezoar. She was treated successfully by gastrotomy with complete evacuation of the trichobezoar.


Bezoar, Trichobezoar, Trichotillomania, Rapunzel Syndrome, Perforation, Gastrotomy.

Subject Discipline


Full Text:


Macksey L. Aspirated bezoar in a pediatric patient: a case study. AANA J 2006; 74(4):295-8.

Gonuguntla V, Joshi D. Rapunzel syndrome: a comprehensive review of an unusual case of a trichobezoar. Clin Med Res 2009; 7(3):99-102.

Gorter RR, Kneepkens CM, Mattens EC, Aronson DC, Heij, HA. Management of trichobezoar: case report and literature review. Pediatr Surg Int 2010; 26(5):457-63.

Phillips MR, Zaheer S, Drugas GT. Gastric trichobezoar: case report and literature review. Mayo Clin Proc 1998; 73:653-56.

Vaughan ED Jr, Sawyers JL, Scott HW Jr. The Rapunzel syndrome. An unusual complication of intestinal bezoars. Surgery 1968; 63:339-43.

Alam M, Khan D. An anemic patient who presented with abdominal pain due to trichobezoar. Saudi Med J 2002; 23(9):1139-40.

Lynch KA, Feola PG, Guenther E. Gastric trichobezoar: an important cause of abdominal pain presenting to the pediatric emergency department. Pediatr Emerg Care 2003; 19(5): 343-47.

Al-Skaini MS, Seleem MI. Trichobezoar: a rare cause of acute bowel obstruction. Saudi Med J 2000; 21(6):585-86.

Shadwan A, Mohammad A. Small bowel obstruction due to trichobezoar: Role of upper endoscopy in diagnosis. Gastrointest Endoscop 2000; 52:784-6.

Billaud Y, Pilleul F, Valette PJ. Mechanical small bowel obstruction due to bezoars: Correlation between CT and surgical findings. J Radiol 2002; 83:641-6.


  • There are currently no refbacks.