Trichotillomania and trichophagia: the causes of Rapunzel syndrome.

Trichotillomania, the repeated action of pulling out one’s own hair for pleasure or sensation of relaxation, and trichophagia, the result of hair eating, usually precede trichobezoar formation. In most patients, the trichobezoar is located in the stomach; however, in a few number of patients, the gastric trichobezoar has a tail and extends through the pylorus into the small bowel and may even reach the colon, being titled as Rapunzel syndrome (1).