Lara-Zavala Yhessica Yhazmin, Álvarez-Ciaca Inés, Montiel-Jarquin Álvaro José, Bertado-Ramírez Nancy Rosalía, García-Galicia Arturo, Alonso-Torres Gisela
Instituto Mexicano del Seguro Social, Centro Médico Nacional "General de División Manuel Ávila Camacho", Hospital de Especialidades de Puebla, Servicio de Radiología. Puebla, Puebla, México.
Instituto Mexicano del Seguro Social, Hospital General de Zona No. 20, Servicio de Radiología. Puebla, Puebla, México.
Rev Med Inst Mex Seguro Soc. 2023 Jul 31;61(4):539-542. doi: 10.5281/zenodo.8200619.
Rapunzel syndrome is a rare presentation of trichobezoar, secondary to the ingestion of hair known as trichophagia. This bezoar has been found mainly in women, it invades the stomach and extends to the small intestine. Clinically, patients present weight loss and chronic obstructive symptoms at the intestinal level. A case of Rapunzel syndrome is presented.
A 13-year-old female presented with a weight loss of 10kg in two months, chronic constipation, predominantly nocturnal vomiting, and abdominal pain of seven days' duration. Physical examination revealed decreased peristalsis and a palpable mass in the epigastrium. Laboratories taken on admission: normal blood count, kidney function tests, and liver function tests. The abdominal X-ray showed opacity in the fundus, body and gastric antrum, the abdominal ultrasound showed non-specific findings in the epigastrium, later an abdominal tomography was performed with a swallow of water-soluble contrast medium and showed occupation in the gastric lumen. She underwent exploratory laparotomy and the finding was a trichobezoar in the stomach with extension to the duodenum and part of the jejunum, which was removed without complications. The evolution of the patient was favorable.
For the diagnosis of Rapunzel Syndrome, the use of contrast imaging studies is necessary, and the treatment of choice is surgical.
长发公主综合征是毛石病的一种罕见表现，继发于吞食毛发即食毛癖。这种毛石主要在女性中发现，它侵入胃并延伸至小肠。临床上，患者表现为体重减轻和肠道水平的慢性梗阻症状。本文报告一例长发公主综合征病例。
一名13岁女性在两个月内体重减轻10kg，伴有慢性便秘、主要为夜间呕吐以及持续7天的腹痛。体格检查发现肠蠕动减弱，上腹部可触及肿块。入院时实验室检查：血常规、肾功能检查和肝功能检查均正常。腹部X线显示胃底、胃体和胃窦部不透光，腹部超声在上腹部显示非特异性结果，随后进行了口服水溶性造影剂的腹部断层扫描，显示胃腔内占位。她接受了剖腹探查术，发现胃内有一个毛石，延伸至十二指肠和部分空肠，手术切除且无并发症。患者恢复良好。
对于长发公主综合征的诊断，使用造影成像检查是必要的，首选治疗方法是手术治疗。
