Abstract
A bezoar is a collection of packed indigestible matter that accumulates in the gastrointestinal tract after ingestion by the patient. It may be made of hair (trichobezoar), vegetable or fruit (phytobezoar), or other indigestible materials. Trichobezoars are thought to form due to hair’s natural enduring nature, as they get matted and stick together in the gut. We present the case of a young female who was 16-weeks pregnant with twins presenting to the general surgery clinic with abdominal pain, vomiting and a palpable abdominal mass, which eventually turned out to be a massive trichobezoar manifesting as Rapunzel syndrome. Rapunzel syndrome is a large trichobezoar extending from the stomach into the small intestine. This is perhaps the first reported case of Rapunzel syndrome in a patient pregnant with twins.
Highlights
A bezoar is a collection of packed indigestible matter that accumulates in the gastrointestinal tract after ingestion by the patient
It may be made of hair, vegetable or fruit, milk curd or other indigestible materials
We present a case of trichobezoar in a young female in her second trimester of pregnancy
Summary
A bezoar is a collection of packed indigestible matter that accumulates in the gastrointestinal tract after ingestion by the patient. A 25-year-old primigravid female presented to the general surgery outpatient clinic with intermittent epigastric pain, which radiated to the left hypochondrium and left shoulder This pain was moderate in severity and had persisted for around two months. The patient had reached her second trimester of pregnancy with no complications in that regard She reported she was pregnant with twins. A large nontender mass was palpated in the epigastric region, extending to the left hypochondrium and umbilical region. The MRI revealed gastric distension with the presence of a soft tissue mass extending throughout the stomach (Figure 1). This confirmed the diagnosis of gastric bezoar, and the patient was admitted as an in-patient and advised for immediate surgery. With an unremarkable postoperative stay, the patient was discharged at the sixth postoperative day, with a follow-up visit scheduled in the surgery clinic
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