ABSTRACT
El síndrome de Rapunzel o tricobezoar es una afección poco frecuente; la perforación gástrica secundaria a éste es excepcional y no se ha encontrado en la actualidad ningún caso en adultos en la literatura médica consultada. Presentamos el caso de un paciente adolescente con cuadro clínico de masa en el epigastrio y abdomen agudo; en el estudio radiológico se objetiva neumoperitoneo y una masa intragástrica. Entre los antecedentes destaca síndrome depresivo y ansiedad. En la laparotomía de urgencia se confirma el diagnóstico de perforación gástrica por tricobezoar que moldea completamente la cámara gástrica. Las imágenes radiológicas hacen sospechar el diagnóstico, pero sólo la laparotomía lo confirma (AU)
Rapunzel syndrome, or trichobezoar, is an uncommon entity and secondary gastric perforation is exceptional. We found no adult cases reported in the literature. Our patient is a teenager with clinical symptoms of epigastric mass and acute abdomen. Radiological study showed pneumoperitoneum and intragastric mass. Personal history revealed depressive syndrome and anxiety. Urgent laparotomy confirmed the diagnosis of gastric perforation due to a trichobezoar completely moulding the gastric chamber. The diagnosis was suspected on the basis of radiologic images but laparotomy was required to confirm it (AU)
Subject(s)
Female , Adolescent , Humans , Intestinal Perforation/diagnosis , Intestinal Perforation/surgery , Bezoars/diagnosis , Bezoars/surgery , Bezoars , Laparotomy/methods , Enzymes/therapeutic use , Asthenia/complications , Asthenia/diagnosis , Abdominal Pain/complications , Abdominal Pain/diagnosis , Abdomen/pathology , Abdomen/surgery , Abdomen , Radiography, Thoracic/methods , Diagnosis, DifferentialABSTRACT
Rapunzel syndrome, or trichobezoar, is an uncommon entity and secondary gastric perforation is exceptional. We found no adult cases reported in the literature. Our patient is a teenager with clinical symptoms of epigastric mass and acute abdomen. Radiological study showed pneumoperitoneum and intragastric mass. Personal history revealed depressive syndrome and anxiety. Urgent laparotomy confirmed the diagnosis of gastric perforation due to a trichobezoar completely moulding the gastric chamber. The diagnosis was suspected on the basis of radiologic images but laparotomy was required to confirm it.
