Chin Xinlin, Ng Jessica Y
Surgery, Mackay Base Hospital, West Mackay, AUS.
School of Medicine, Griffith University, Birtinya, AUS.
Cureus. 2021 Dec 28;13(12):e20785. doi: 10.7759/cureus.20785. eCollection 2021 Dec.
Bezoars have different compositions and can be subdivided into trichobezoar, phytobezoar, pharmacobezoar, lactobezoar and food bolus. The reported incidence of bezoar is 0.4% with phytobezoar being the commonest. Rapunzel syndrome is an extremely rare complication when trichobezoar crosses the pylorus to enter the duodenum, ileum and colon. We present the case of a 29-year-old female with a one-week history of abdominal pain, anorexia, nausea, vomiting, constipation, lethargy and a one-year history of increasing abdominal mass. Physical examination revealed a 20 cm palpable mass extending from the left upper quadrant to the umbilicus. Laboratory investigations demonstrated iron deficiency anemia and CT showed two well-defined foci within the gastric lumen consistent with trichobezoars. She was managed conservatively during her hospital stay and discharged home with a plan for elective laparotomy. We present this case to discuss the management of trichobezoars and to highlight the importance of early recognition of recurrence to avoid severe complications.
胃石有不同的成分，可细分为毛胃石、植物性胃石、药物性胃石、乳石和食团。报道的胃石发病率为0.4%，其中植物性胃石最为常见。长发公主综合征是一种极其罕见的并发症，即毛胃石穿过幽门进入十二指肠、回肠和结肠。我们报告一例29岁女性病例，她有一周的腹痛、厌食、恶心、呕吐、便秘、嗜睡病史，还有一年腹部肿块逐渐增大的病史。体格检查发现一个可触及的20厘米肿块，从左上腹延伸至脐部。实验室检查显示缺铁性贫血，CT显示胃腔内有两个边界清晰的病灶，符合毛胃石表现。她在住院期间接受了保守治疗，出院时计划择期行剖腹手术。我们展示此病例以讨论毛胃石的处理，并强调早期识别复发以避免严重并发症的重要性。
