Rodríguez GHM, Schleske Ra

Language: Spanish
References: 14
Page: 113-117
PDF size: 188.44 Kb.

ABSTRACT

Objective: To describe the case of a 14-year-old female adolescent, who presented with chronic abdominal pain in the epigastrium, nausea, vomiting, immediate satiety, and a tumoral mass in the epigastrium.
Design: Description of a clinical case, retrospectively, of a female patient with chronic abdominal pain at the epigastrium.
Setting: Third level health care hospital.
Case description: Female adolescent, 14-year-old, who presents at the hospital with abdominal pain of 3 months evolution, nausea, vomiting, early satiety, anorexia, weight loss of 10 kg. Physical exploration revealed thin body constitution, pallor, alopecia. Abdominal exploration revealed the presence of a long, curvilinear, well-defined intra-abdominal mass, occupying the epigastric and left hypochondriac regions.
Conclusion: Bezoars have been known for more than 200 years. They are more common in children, and the trichobezoar is most common in the pediatric age; more than 90% occurring in young women (‹ 20 years); men are rarely affected. Trichobezoars are frequently associated with mental retardation, emotional disorders (trichotillomania and trichophagia), alopecia can be encountered, it presents with abdominal or epigastric pain, nausea, vomiting, and weight loss. Pain in the epigastrium or a palpable mass in the upper left quadrant are suggestive of trichobezoar, requiring surgical removal, through an anterior gastrostomy. Psychiatric intervention and management are imperative to avoid recurrence.

REFERENCES

1. Sundaram B, Selvarajan N, Somu S, Kamalanathan AN. Tricobezoar. Arch Dis Child 2003; 88: 378.

2. Vera SDA, Geling de Alba G, Kuri OJA, Sandoval RJM. Tricobezoar recidivante informe de un caso. Cir Gen 2002; 24 (Supl 1): S66.

3. Mondragón RSP, Delgado CCA, Yánez LA, Sifuentes BJH, Salinas VJC. Síndrome de Rapunzel. Nuevo reporte de una rara manifestación del Tricobezoar gástrico. Cir Gen 2004; 26 (Supl1): S75.

4. Guzmán OJD, Martínez LMS, Rosales MJ. Tricobezoar gástrico gigante. Cir Gen 2001; 23 (Supl 1): S140.

5. Vaughan ED Jr, Sawyers JL, Scott HW Jr. The Rapunzel syndrome. An unusual complication of intestinal bezoar. Surgery 1968; 63: 339-43.

6. Fronstin MH, Hutcheson JB. Trichobezoar as a cause of obstruction of the colon. Am Surg 1967; 33: 475-7.

7. Frey AS, Mc Kee M, King RA, Martin A. Hair Apparent: Rapunzel Syndrome. Am J Psychiatry 2005; 162: 242-248.

8. Correa AMI, Serrano CA, Pimentel LJJ, Sanjuán RS. Bezoar gástrico. Cir Pediatr 2001; 14: 82-84.

9. Lynch KA, Feota PG, Guenther E. Gastric trichobezoar: an important cause of abdominal pain presenting to the pediatric emergency department. Pediatr Emerg Care 2003; 19: 343-347.

10. Sesman BA, Martínez OJL, Sánchez FP, Blanco BR. Tricobezoar gástrico. Reporte de un caso. Cir Gen 2001; 23 (Supl 1): S140

11. Azizzadeh A, Moldovan S, Scout BG. Image of the month. Rapunzel syndrome. Arch Surg 2002; 137: 1443-44.

12. Lanoue JL, Arkovitz MS. Images in clinical medicine. Trichobezoar in a four-year-old girl. N Engl J Med 2003; 348: 1242.

13. Dillon PW. Lesiones del estómago. En: Ashcraft KW. Cirugía Pediátrica 3Ş. Edición México, DF, McGraw-Hill Interamericana 2002 p. 421.

14. Ramadan N, Pandya NA, Bhaduri B. A Rapunzel with a difference. Arch Dis Child 2003; 88: 264.