Perzabal ACT, Cárdenas GD, López JCA

Language: Spanish
References: 18
Page: 21-24
PDF size: 175.23 Kb.

ABSTRACT

Introduction: A bezoar is a collection of non-digestible organic or inorganic material in the gastrointestinal tract. Depending on their composition they are classified as phytobezoar, pharmacobezoar, trichobezoar, and lactobezoar. If a trichobezoar spreads through the pylorus, it is called Rapunzel syndrome. Case report: This is a female patient, 16 years of age with a history of psychomotor retardation and epilepsy. She began her complaints seven days before admission with coffee ground vomitus. Two days before, she presented the same condition again, starting treatment with omeprazole and ranitidine, without improvement. Due to this event, she went to the emergency department, where she was hospitalized. An endoscopy was requested where the presence of an apparent trichobezoar was observed in the stomach. She was then taken to the operating room and under general anesthesia, proceeded to the placement of five laparoscopic ports. A diagnostic laparoscopy was performed, observing an increase in the volume of the gastric chamber. A longitudinal incision was made in the stomach and the bezoar, mostly made up of hair, and food debris, shoelaces, and fragments of plastic bags were completely extracted. This occupied the entire gastric chamber with the extension of detritus and textiles into the duodenum. The bezoar was placed in an endoscopic bag and then extracted by expanding one of the work ports. Conclusions: Although the gold standard for the treatment of Rapunzel syndrome continues to be a laparotomy, the laparoscopic approach is feasible and, if successful, has a favorable postoperative evolution, with the known advantages of this type of approach.

REFERENCES

1. Mansoor J, Ahmed M, Junaid Z. Rapunzel syndrome: A rare cause of upper gastro intestinal obstruction. Pak Armed Forces Med J. 2014; 64: 502-504.

2. Saleem MI, Mohamed DH, Ahmad MA, Nafae A, Ahmed F, Bashir BS. Laparoscopic management of a giant trichobezoar causing Rapunzel syndrome: A case report. Arch Clin Exp Surg. 2017; 6: 41-44.

3. Ortiz-Soto JM, Suárez-Nadal JE, Nava-Carillo AD, Cruz-Martínez EA, Dávila-Jolly H. Tricotextilo bezoar, síndrome de Rapunzel. Presentación de un caso. Rev Mex Cir Pediatr. 2005; 12: 51-54.

4. Lalith S, Gopalakrishnan KL, Ilangovan G, Venkataraman S, Jayajothi A. Rapunzel syndrome. Journal of Clinical and Diagnostic Research. 2017; 11: TD01-TD02.

5. Morales-Fuentes B, Camacho-Maya U, Coll-Clemente FL, Vázquez-Minero JC. Tricotilomanía, tricobezoar de repetición y síndrome de Rapunzel. Informe de un caso y revisión de la literatura. Cir Cir. 2010; 78: 265-268.

6. Chauhan NS, Kumar S, Bhoil R. Rapunzel Syndrome: Rare “Tale” of a Broken “Tail”. Pol J Radiol. 2016; 81: 166-169.

7. Bilommi R. Rapunzel síndrome: A case report. Journal of Pediatric Surgery Case Reports. 2017; 21: 33-35.

8. Uçmak F, Beştaş R, Adanır H, Ekin N, Tardu A. A rare cause of abdominal mass: Rapunzel syndrome. JCEI. 2016; 7: 87-90.

9. Athanasiou A, Michalinos A, Moris D, Spartalis E, Dimitrokallis N, Kaminiotis V et al. Rapunzel syndrome: A rare presentation with giant gastric ulcer. Case Reports in Medicine. 2014; 2014: 1-4.

10. Mansoor J, Ahmed M, Junaid Z. Rapunzel syndrome: A rare cause of upper gastro intestinal obstruction. Pak Armed Forces Med J. 2014; 64: 502-504.

11. Saleem MI, Mohamed DH, Ahmad MA, Nafae A, Ahmed F, Bashir BS. Laparoscopic management of a giant trichobezoar causing Rapunzel syndrome: A case report. Arch Clin Exp Surg. 2017; 6: 41-44.

12. Ortiz-Soto JM, Suárez-Nadal JE, Nava-Carillo AD, Cruz-Martínez EA, Dávila-Jolly H. Tricotextilo bezoar, síndrome de Rapunzel. Presentación de un caso. Rev Mex Cir Pediatr. 2005; 12: 51-54.

13. Lalith S, Gopalakrishnan KL, Ilangovan G, Venkataraman S, Jayajothi A. Rapunzel syndrome. Journal of Clinical and Diagnostic Research. 2017; 11: TD01-TD02.

14. Morales-Fuentes B, Camacho-Maya U, Coll-Clemente FL, Vázquez-Minero JC. Tricotilomanía, tricobezoar de repetición y síndrome de Rapunzel. Informe de un caso y revisión de la literatura. Cir Cir. 2010; 78: 265-268.

15. Chauhan NS, Kumar S, Bhoil R. Rapunzel Syndrome: Rare “Tale” of a Broken “Tail”. Pol J Radiol. 2016; 81: 166-169.

16. Bilommi R. Rapunzel síndrome: A case report. Journal of Pediatric Surgery Case Reports. 2017; 21: 33-35.

17. Uçmak F, Beştaş R, Adanır H, Ekin N, Tardu A. A rare cause of abdominal mass: Rapunzel syndrome. JCEI. 2016; 7: 87-90.

18. Athanasiou A, Michalinos A, Moris D, Spartalis E, Dimitrokallis N, Kaminiotis V et al. Rapunzel syndrome: A rare presentation with giant gastric ulcer. Case Reports in Medicine. 2014; 2014: 1-4.