Small-Bowel Obstruction Secondary to Trichobe...

Small-Bowel Obstruction Secondary to Trichobezoar in a Patient with Rapunzel Syndrome: Case Report

Author Name : Fernando Tellez-Pallares, Luis Eduardo Cruz Corzo, Eugenio Martinez Ceballos, Angel Rodriguez Castillo

ABSTRACT

Objective:To present a case and review the literature on the behavior and complications of bezoars.Bezoars are concretions in the gastrointestinal tract that increase in size by continuous accumulation of non-absorbable food or fibers. Rapunzel syndrome is a very rare and complex entity where there is extension of the gastric bezoar to the duodenum and small intestine, which increases the risks of complications such as obstruction, perforation and peritonitis.

The formation is due to the continuous ingestion of hair which leads to its impaction together with mucus and food, but gastric perforation is infrequent.The goal of treatment is mechanical removal of the trichobezoar and prevention of recurrence with psychiatric therapy, Laparotomy is currently considered the treatment of choice.

Case Report: We present the clinical case of a female patient who showed recurrent peritonitis associated with a peritoneal dialysis catheter, anorexia, nausea, vomiting, without presenting evacuations, epigastric mass, anxiety, trichotillomania and trichophagia. Rapunzel syndrome is diagnosed and the admission to the operating room is decided for resolution.

Keywords: Rapunzel syndrome,Gastric trichobezoar;Small-bowel trichobezoar; Trichobezoar, Abdominal Pain.