Innovations in Pharmaceutical Sciences & Care

Rapunzel syndrome is a rare form of trichobezoar in which a gastric hair mass extends beyond the pylorus, potentially causing obstruction and serious complications, whereas gallbladder involvement is exceptionally uncommon. This report described a unique pediatric case of Rapunzel syndrome with jejunal and gallbladder extension and highlighted diagnostic and management considerations. A 12-year-old girl with a four-year history of trichotillomania and trichophagia presented with two weeks of abdominal pain, nausea, vomiting, progressive distension, early satiety and weight loss. Examination revealed a palpable epigastric mass and patchy alopecia; however, laboratory studies showed mild anaemia. Further, abdominal ultrasonography demonstrated an intragastric echogenic mass with duodenal extension and echogenic material within the gallbladder. Computed tomography confirmed a large gastric trichobezoar extending into the jejunum with gallbladder involvement, without perforation. The patient underwent exploratory laparotomy with gastrotomy and cholecystotomy, achieving complete removal. Recovery was uneventful, and psychiatric follow-up was initiated to prevent recurrence. This case underscores the need for early imaging to define atypical extensions and supports definitive surgical management combined with multidisciplinary recurrence-prevention strategies.