A rare variant of rapunzel syndrome-acute small bowel obstruction caused by ball of hairs in distal ileum with its tail extending in caecum and ascending colon

Rapunzel syndrome is an extremely rare variant of trichobezoar. trichobezoar commonly occurs in patients with psychiatric disturbances as trichophagia (morbid habit of chewing the hair) and trichotillomania (habit of hair pulling). bezoars are commonly found in the stomach. in very rare cases of rapunzel syndrome,hair extends through the pylorus into the small bowel and very uncommonly in large intestine causing symptoms and signs of partial or complete intestinal obstruction. a case report of a rare variant of rapunzel syndrome,where ball of hairs in small bowel with its tail extending in caecum and ascending colon causing acute small bowel obstruction,is reported in a 13-year-old girl. © 2016,pakistan medical association. all rights reserved.