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一名14岁女孩的长发公主综合征病例报告。

A Case Report of Rapunzel Syndrome in 14-Year-Old Girl.

作者信息

Stamov Petar, Zlatarov Aleksandar, Mihaylov Stefan

机构信息

Department of General and Operative Surgery, Medical University "Prof. Dr. Paraskev Stoyanov", Varna, BGR.

出版信息

Cureus. 2024 Nov 25;16(11):e74446. doi: 10.7759/cureus.74446. eCollection 2024 Nov.

Abstract

Trichobezoar or hairball in the proximal part of the gastrointestinal tract is a rare condition that occurs mainly in young and adolescent females. Since human hair is resistant to digestive enzymes and resistant to peristalsis, it easily accumulates between the folds of the mucosa. Over time, food and mucus accumulate within the hair, forming a compact mass that fills almost the entire lumen. When a trichobezoar passes through the pylorus and reaches the duodenum, and in some cases even the jejunum, it is referred to as Rapunzel syndrome. The treatment is surgical. Depending on the location and size of the trichobezoar, it can be removed endoscopically, laparoscopically, or by conventional laparotomy. Our report aims to present the surgical treatment of Rapunzel syndrome, as part of a comprehensive approach to this disease. We present a 14-year-old girl who was diagnosed and treated in our department. According to the world practice and our experience, conventional laparotomy as a method of treatment remains the first choice. The smaller gastrointestinal trichobezoars are asymptomatic or with unusual clinical manifestations. They grow undetected and combined with mental disorders can lead to significant gastrointestinal complications such as mainly intestinal obstruction and rarely erosions, ulcers, and perforation. The treatment is multimodal including surgeons, pediatricians, and psychiatrists.

摘要

胃肠道近端的毛粪石或胃石是一种罕见病症,主要发生在年轻女性和青少年女性中。由于人类毛发对消化酶具有抗性且抵抗蠕动,它很容易在粘膜褶皱间积聚。随着时间的推移,食物和黏液在毛发内积聚,形成一个几乎填满整个管腔的紧实团块。当毛粪石通过幽门到达十二指肠,在某些情况下甚至到达空肠时,就被称为长发公主综合征。治疗方法是手术。根据毛粪石的位置和大小,可以通过内镜、腹腔镜或传统剖腹手术将其切除。我们的报告旨在介绍长发公主综合征的手术治疗,作为对该疾病综合治疗方法的一部分。我们报告了一名在我们科室确诊并接受治疗的14岁女孩。根据世界惯例和我们的经验,传统剖腹手术作为一种治疗方法仍然是首选。较小的胃肠道毛粪石无症状或有不寻常的临床表现。它们在未被察觉的情况下生长,并且与精神障碍相结合可导致严重的胃肠道并发症,如主要是肠梗阻,很少有糜烂、溃疡和穿孔。治疗是多模式的,包括外科医生、儿科医生和精神科医生。

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