Chun Sang Woo, Lee Kunsong, Park Youn Joon, Shin Hyun Deok
Department of Pediatrics, Dankook University College of Medicine, Cheonan, Korea.
Department of Pediatric Surgery, Dankook University College of Medicine, Cheonan, Korea.
Korean J Gastroenterol. 2019 Jul 25;74(1):42-45. doi: 10.4166/kjg.2019.74.1.42.
A trichobezoar is a type of bezoar that is composed of hair. In most cases, it is confined to the stomach, but in rare cases, it may extend to the small intestine. This condition is referred to as Rapunzel syndrome. The therapeutic method for bezoar removal depends on its type, location, and size. Generally, the treatment for Rapunzel syndrome involves surgical laparotomy. Endoscopic removal has also been effective in some cases. On the other hand, complications, such as respiratory difficulty and esophageal impaction may be encountered during endoscopic removal. Until now, the successful endoscopic removal of trichobezoars has been limited to the stomach or duodenum. This paper reports the case of a 4-year-old female patient with Rapunzel syndrome whose trichobezoar reached the proximal jejunum. The trichobezoar was removed without complications using an electrosurgical knife and snare through a single-balloon enteroscopy. The trichobezoar can be removed successfully using enteroscopy under general anesthesia without abdominal laparotomy in young children. Therefore, this method of removal can be considered preferentially for children with Rapunzel syndrome.
毛粪石是一种由毛发组成的粪石。在大多数情况下,它局限于胃,但在极少数情况下,可能会延伸至小肠。这种情况被称为长发公主综合征。粪石清除的治疗方法取决于其类型、位置和大小。一般来说,长发公主综合征的治疗需要进行外科剖腹手术。在某些情况下,内镜下清除也有效。另一方面,在内镜清除过程中可能会遇到诸如呼吸困难和食管嵌塞等并发症。到目前为止,成功的内镜下毛粪石清除仅限于胃或十二指肠。本文报告了一例4岁患有长发公主综合征的女性患者,其毛粪石已到达空肠近端。通过单气囊小肠镜使用电刀和圈套器成功地清除了毛粪石,且无并发症。在幼儿中,在全身麻醉下通过小肠镜可以成功清除毛粪石而无需进行剖腹手术。因此,对于患有长发公主综合征的儿童,可以优先考虑这种清除方法。