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A 14-year-old girl with no psychiatric background presented with painful epigastric mass and vomiting. Physical examination showed emaciated appearance, epigastric swelling, hair loss and halitosis. Abdominal ultrasound identified a hyperechoic curvilinear mass with acoustic shadowing. Abdominal CT revealed a heterogeneous image in the gastric lumen, suspicious of trichobezoar (figure 1). An upper gastrointestinal endoscopy identified a ‘comet tail’ extension to duodenum suggestive of Rapunzel syndrome.
Contributors HA, CB and CF wrote the manuscript. CB edited the images. JC-P reviewed the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Parental/guardian consent obtained.
Ethics approval Comissão de Ética para a Saúde do Hospital de Braga (CESHB).
Provenance and peer review Not commissioned; internally peer reviewed.
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