# Rapunzel syndrome: emergency laparoscopic management

## TL;DR

A rare case of Rapunzel syndrome was successfully treated with emergency laparoscopic surgery, highlighting the importance of addressing both physical and psychiatric health.

## Contribution

The paper presents a successful case of emergency laparoscopic management for Rapunzel syndrome with coordinated psychiatric follow-up.

## Key findings

- Emergency laparoscopic surgery successfully extracted a large gastric trichobezoar.
- Multidisciplinary management including psychiatric care is essential to prevent recurrence.
- Timely diagnosis and minimally invasive treatment led to favorable postoperative recovery.

## Abstract

Rapunzel syndrome is a rare form of trichobezoar, typically associated with an underlying and often untreated psychiatric disorder such as trichotillomania. This case report describes a 24-year-old female patient previously diagnosed with trichotillomania and trichophagia, who presented with abdominal distension and vomiting due to a large gastric bezoar extending into the duodenum. Diagnostic evaluation included upper endoscopy and computed tomography, confirming complete upper gastrointestinal obstruction. Emergency laparoscopic management was successfully performed, allowing complete extraction of the trichobezoar, followed by gastric repair. Postoperative recovery was favorable, and psychiatric follow-up was initiated to address the underlying condition and reduce the risk of recurrence. Timely diagnosis enables successful minimally invasive surgical treatment and underscores the need for coordinated multidisciplinary management.