Trichophagia and Trichobezoar: Case Report

Santos Tiago a, *, Madeira Nuno b, Alcafache João a, Vicente Carla a, Molinar Gonçalo c, Noronha Joana c
a Department of Psychiatry and Mental Health, Hospital Infante D. Pedro, Aveiro, Portugal
b Psychiatry Clinic, Coimbra University Hospital, Coimbra, Portugal
c Department of General Surgery, Infante D. Pedro Hospital, Aveiro, Portugal

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© Tiago et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Psychiatry and Mental Health, Hospital Infante D. Pedro Rua Artur Ravara 3810-AVEIRO Portugal; Tel: +351 93 6673106; Fax: 234 378 395; E-mail:



Trichobezoar consists of a compact mass of hair occupying the gastric cavity to a various extent. When the trichobezoar extends past the duodenum it is better referred to as Rapunzel Syndrome. Although trichobezoars are well described in terms of surgical diagnostic and procedure, there are only but very scarce reports on psychiatric literature, usually associated with trichotillomania. The authors present a clinical case of trichobezoar and discuss the most relevant aspects concerning this entity.


Presentation of psychiatric and surgical data concerning the case report. Previously reported cases are also mentioned.


Report of a 27-year-old female patient with a trichobezoar submitted to surgical removal, with a prior intervention 4 years before also due to trichobezoar, and with unknown psychiatric antecedents or follow-up.


A trichobezoar represents a serious surgical condition. It is important to consider such diagnosis in face of suggestive symptoms, even if signs of trichotillomania are not present. The discrepancies between the prevalence of trichotillomania and trichobezoars due to trichophagia may be due to issues related to self-selection of patients and symptom severity. Such issues may also be important in the study of impulsive-compulsive spectrum models and to their relevance to impulse control disorders.

Keywords: Trichobezoar, Rapunzel Syndrome, Trichotillomania, Trichophagia.