Chronic gastric obstruction due to giant trichobezoar in an adult with Rapunzel syndrome

A 46-year-old woman was admitted to psychiatric ward accomanied by parents for delirium during acute phase of psychosis. uring following days a voluminous non-painful mass in the left pper quadrant of abdomen was noted. Detailed studies of medcal history reveal a story of nausea and vomiting during last onths and weight loss. A contrast enhanced CT scan was perormed and the images were suggestive for impressive gastric ilatation sustained by a giant bezoar (Fig. 1). The diagnosis was hen confirmed during endoscopic procedure during which was mpossible to remove the bezoar due to impossibility to fragment t in smaller pieces. A laparotomy was planned, the trichobezoar as removed through a 10 cm longitudinal gastrotomy on the nterior gastric wall (Fig. 2). The gastrotomy was repaired with linar mechanical stapler and a reinforcement with manual suture.