Rapunzel syndrome:A rare presentation with multiple small intestinal intussusceptions  

作　　者：Bidarahalli Krishna Prasanna Kuppusamy Sasikumar Uppinakudru Gurunandan Gubbi Shamanna Sreenath Vikram Kate 

机构地区：[1]Department of Surgery,Jawaharlal Institute of Postgraduate Medical Education and Research

出　　处：《World Journal of Gastrointestinal Surgery》2013年第10期282-284,共3页世界胃肠外科杂志（英文版）（电子版）

摘　　要：Bezoars are usually confined to the stomach which is seen in individuals with psychiatric illness like trichotillomania,trichophagia and gastric dysmotility.Long standing bezoars may extend into the small intestine leading to a condition known as Rapunzel syndrome.Diagnosis can be established by endoscopy,ultrasonography and computed tomography scan.Treatment includes improvement of general condition and removal of bezoar by laparoscopic approach or laparotomy.Psychiatric consultation is necessary to treat and prevent relapse.We report a case of Rapunzel syndrome in a 16-yearold girl with trichotillomania.She presented with history of epigastric mass for three months and recent onset of pain abdomen,vomiting and early satiety.Skiagram of abdomen was showing distended stomach and endoscopy revealed trichobezoar.At laparotomy,stomach was distended with trichobezoar and there were multiple small intestinal intussusceptions.Gastrotomy and manual reduction of intussusceptions with the removal of trichobezoar with its tail was done.Patient recovered completely after the procedure.Bezoars are usually confined to the stomach which is seen in individuals with psychiatric illness like trichotillomania,trichophagia and gastric dysmotility.Long standing bezoars may extend into the small intestine leading to a condition known as Rapunzel syndrome.Diagnosis can be established by endoscopy,ultrasonography and computed tomography scan.Treatment includes improvement of general condition and removal of bezoar by laparoscopic approach or laparotomy.Psychiatric consultation is necessary to treat and prevent relapse.We report a case of Rapunzel syndrome in a 16-yearold girl with trichotillomania.She presented with history of epigastric mass for three months and recent onset of pain abdomen,vomiting and early satiety.Skiagram of abdomen was showing distended stomach and endoscopy revealed trichobezoar.At laparotomy,stomach was distended with trichobezoar and there were multiple small intestinal intussusceptions.Gastrotomy and manual reduction of intussusceptions with the removal of trichobezoar with its tail was done.Patient recovered completely after the procedure.

关 键 词：Rapunzel SYNDROME TRICHOBEZOAR TRICHOTILLOMANIA INTUSSUSCEPTION 

分 类 号：R573.8[医药卫生—消化系统]