Durkhure Rakesh, Singh J P, Singhal Vinay
Department of surgery, Vardhman Mahavir Medical College, Safdar Jang Hospital, New Delhi-India.
BMC Surg. 2003 Sep 4;3:5. doi: 10.1186/1471-2482-3-5.
Bezoars usually present as a mass in the stomach. The patient often has a preceding history of some psychiatric predisposition. Presentation could be in the form of trichophagy followed by trichobezoar (swallowing of hair leading to formation of bezoar), orphytobezoar (swallowing of vegetable fibres). Rapunzel syndrome is a condition where the parent bezoar is in the stomach and a tail of the fibres or hair extends in to the jejunum. Presentation as intestinal obstruction due to a bezoar in the intestine without a parent bezoar in the stomach is rare, therefore we report it here.
A 35 year old lady tailor with a previous history of receiving treatment for depression on account of being infertile- years after her marriage, presented to the surgical emergency department with features of acute intestinal obstruction. Exploratory laparotomy and enterotomy revealed a cotton bezoar in the terminal ileum without a parent bezoar in the stomach. She was managed by resection of the affected segment of the ileum and end-to-end anastomosis of the bowel. In the postoperative period the patient gave a history of ingesting cotton threads whenever she was depressed.
Presence of cotton bezoar is rare and an intestinal bezoar in the absence of parent bezoar in the stomach is still rarer.
胃石通常表现为胃内的肿块。患者常有某种精神方面易患病体质的既往史。表现形式可能先是食毛癖，随后形成毛石（吞食毛发导致胃石形成），或者是植物性胃石（吞食植物纤维）。长发公主综合征是一种情况，即母胃石在胃内，而纤维或毛发的尾部延伸至空肠。因肠道内胃石导致肠梗阻而胃内无母胃石的情况较为罕见，因此我们在此报告。
一名35岁的女裁缝，婚后多年因不孕接受过抑郁症治疗，因急性肠梗阻症状就诊于外科急诊室。剖腹探查和肠切开术显示回肠末端有一个棉胃石，胃内无母胃石。对她进行了回肠受累段切除及肠端端吻合术治疗。术后患者称每当情绪低落时就会吞食棉线。
棉胃石罕见，胃内无母胃石而肠道内有胃石的情况更为罕见。
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