Nwankwo Eugene, Daniele Edward, Woller Erin, Fitzwater John, McGill Thomas, Brooks Steven E
Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street MS 8312, Lubbock, TX 79430, United States.
Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street MS 8312, Lubbock, TX 79430, United States.
Int J Surg Case Rep. 2017;34:123-125. doi: 10.1016/j.ijscr.2017.03.011. Epub 2017 Mar 16.
Rapunzel syndrome is a rare intestinal condition that starts with the ingestion of a trichobezoar. The condition is predominately found in females and can be associated with trichotillomania, or the compulsive urge to pull one's own hair out. There are less than 40 cases described in the literature with the prevention of recurrence aimed at psychological treatment.
The patient is a 7 year-old girl with a history of trichotillomania with trichophagia as a young child who presented with abdominal pain, nausea, and vomiting, consistent with a gastric outlet obstruction. She had an exploratory laparotomy with gastrostomy performed revealing a 18cm by 18cm trichobezoar with extension into the small bowel.
Bezoars, an already rare entity, can occasionally lead to gastric and small bowel obstructions. Small collections of ingested hair build up in the intestinal tract causing significant symptoms. These obstructions can sometimes be treated through minimally invasive techniques but, in our case described, it is unlikely to have been treated any other way due to the substantial size of the trichobezoar.
Early consideration of Rapunzel syndrome is important in young females presenting with a gastric outlet obstruction.
长发公主综合征是一种罕见的肠道疾病，始于吞食毛石。这种疾病主要见于女性，可能与拔毛癖有关，即强迫性地拔自己的头发。文献中描述的病例不到40例，预防复发的方法主要是心理治疗。
该患者是一名7岁女孩，幼儿期有拔毛癖伴食毛症病史，现出现腹痛、恶心和呕吐，符合胃出口梗阻的表现。她接受了剖腹探查术并进行了胃造口术，发现一个18厘米×18厘米的毛石，延伸至小肠。
毛石本身就是一种罕见的病症，偶尔可导致胃和小肠梗阻。摄入的少量毛发在肠道内积聚，引发严重症状。这些梗阻有时可通过微创技术治疗，但在我们描述的病例中，由于毛石体积较大，不太可能采用其他治疗方法。
对于出现胃出口梗阻的年轻女性，早期考虑长发公主综合征很重要。
