15
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Revelation of Rapunzel syndrome: A rare case report of gastric trichobezoar-induced acute purulent peritonitis

      case-report

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Introduction and importance

          The Rapunzel syndrome embodies an uncommon variation of trichobezoar, predominantly observed among individuals with a history of psychiatric conditions, trichotillomania, and trichophagia. This combination of factors predisposes to the eventual formation of gastric bezoars. Trichobezoars, infrequent gastric masses composed of hair, can lead to complications if left untreated.

          Case report

          A 19-year-old female hairdresser with a history of trichophagia sought medical attention due to abdominal pain and episodes of vomiting. With an elevated body temperature and abdominal rigidity, imaging revealed the presence of a trichobezoar, accompanied by pneumoperitoneum and intraperitoneal effusion. Urgent surgical intervention confirmed the diagnosis of generalized purulent acute peritonitis, triggered by a gastric perforation caused by a 20 cm trichobezoar with an extension into the duodenum, which defines the Rapunzel syndrome. Gastrotomy was performed to remove the trichobezoar, followed by thorough peritoneal lavage.

          Clinical discussion

          Trichobezoar is a rare condition that involves the abnormal accumulation of solid substances, particularly hair, within the stomach. Known as “Rapunzel syndrome,” it can extend into the duodenum or jejunum. Commonly associated with emotional disorders, trichobezoar can lead to symptoms like epigastric discomfort, vomiting, and weight loss. Diagnosis is through endoscopy, and treatments include fluid intake, endoscopic extraction, chemical dissolution, and surgical removal. Surgical intervention is often preferred, with laparoscopic approaches considered. Psychiatric management is often required for patients.

          Conclusion

          This case underscores the uncommon Rapunzel syndrome presentation, emphasizing timely surgical measures and multidisciplinary care for trichobezoars causing acute peritonitis.

          Highlights

          • The Rapunzel syndrome: A rare trichobezoar in individuals with psychiatric conditions, trichotillomania, and trichophagia, leading to gastric bezoars.

          • Unconventional case study: 19-year-old hairdresser diagnosed with trichobezoar-induced purulent peritonitis.

          • Early detection and multidisciplinary care: Emphasizing the importance of recognizing it early, undergoing surgery, and providing comprehensive patient care in Trichobezoar-Related Rapunzel Syndrome.

          Related collections

          Most cited references17

          • Record: found
          • Abstract: found
          • Article: not found

          The SCARE 2020 Guideline: Updating Consensus Surgical CAse REport (SCARE) Guidelines

          The SCARE Guidelines were first published in 2016 and were last updated in 2018. They provide a structure for reporting surgical case reports and are used and endorsed by authors, journal editors and reviewers, in order to increase robustness and transparency in reporting surgical cases. They must be kept up to date in order to drive forwards reporting quality. As such, we have updated these guidelines via a DELPHI consensus exercise.
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            The Rapunzel syndrome. An unusual complication of intestinal bezoar.

              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Systematic review: Coca-Cola can effectively dissolve gastric phytobezoars as a first-line treatment.

              Gastric phytobezoars represent the most common bezoars in patients with poor gastric motility. A variety of dissolution therapies and endoscopic fragmentation techniques have been evaluated as conservative treatment so as to avoid surgery. To investigate the effectiveness of Coca-Cola for gastric phytobezoars dissolution. We performed a systematic search to identify publications on gastric phytobezoars to assess the efficacy of Coca-Cola as a dissolution therapy. Diospyrobezoars, formed after persimmon ingestion, are a distinct type of phytobezoars characterized by their hard consistency. Thus, these two subgroups of bezoars were compared in terms of successful dissolution. Over a 10-year period (2002-2012), 24 papers including 46 patients have been published. In 91.3% of the cases, phytobezoar resolution with Coca-Cola administration was successful, either as a single treatment (50%) or combined with further endoscopic techniques, whereas only 4 patients underwent surgery. Phytobezoars were more likely to dissolve after initial attempt with Coca-Cola compared with diospyrobezoars (60.6% vs. 23%, P = 0.022). Coca-Cola alone is effective in gastric phytobezoar dissolution in half of the cases and, combined with additional endoscopic methods, is successful in more than 90% of them. © 2012 Blackwell Publishing Ltd.
                Bookmark

                Author and article information

                Contributors
                Journal
                Int J Surg Case Rep
                Int J Surg Case Rep
                International Journal of Surgery Case Reports
                Elsevier
                2210-2612
                22 September 2023
                October 2023
                22 September 2023
                : 111
                : 108860
                Affiliations
                General Surgery Department, Mahmoud El Matri Hospital, V59M+628 Ariana, Tunisia
                Faculty of Medicine of Tunis, University of Tunis El Manar, Rue de la Faculté de Médecine, R534+F9H Tunis, Tunisia
                Author notes
                [* ]Corresponding author at: Cité Ennaser 2, Ariana 2027, Tunisia. dhekertouati@ 123456hotmail.com
                Article
                S2210-2612(23)00989-6 108860
                10.1016/j.ijscr.2023.108860
                10520814
                37748384
                79d0278d-7fe1-4fea-82ae-1dc6bac7f521
                © 2023 The Author(s)

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 15 August 2023
                : 19 September 2023
                : 19 September 2023
                Categories
                Case Report

                trichobezoar,gastric perforation,acute peritonitis,surgical intervention,rapunzel syndrome,trichophagia

                Comments

                Comment on this article

                scite_
                0
                0
                0
                0
                Smart Citations
                0
                0
                0
                0
                Citing PublicationsSupportingMentioningContrasting
                View Citations

                See how this article has been cited at scite.ai

                scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.

                Similar content501

                Most referenced authors227