Rapunzel-Syndrome, an unusual cause of intestinal trichobezoar

Rapunzel syndrome is a rare cause of intestinal trichobezoar. Especially ad olescent girls with uncharacteristical abdominal symptoms as well as weight loss and trichophagia are affected. The symptoms are caused by large amoun ts of swallowed hair within the stomach which can extend far into the intes tinuum. Beside conventional radiology and sonography the diagnostic procedu re of choice is endoscopy. If endoscopic removal of the bezoar fails surgic al intervention is mandatory. As many of these patients show emotional diso rders psychiatric evaluation and treatment has to be done to prevent recurr ence. We report on a 12 year old girl with a huge trichobezoar which completely f illed the stomach and extended far into the small bowel. As the bezoar coul d not completely be removed by endoscopy the girl had to be treated by surg ery.