Síndrome de Rapunzel. Reporte de un caso

Abstract

Bezoars are accumulations of non-digestible material in the gastrointestinal tract; classified according to the material that it is composed. They are called trichobezoars to those who are formed by the hair, and when are extended to the gastric chamber are called Rapunzel syndrome. It presents mainly in teenagers associated with psychiatric disorders. It has different clinical manifestations and the upper gastrointestinal endoscopy is the gold standard for its diagnosis. We present a case of a Rapunzel Syndrome in an 18 years old patient who was admitted due to abdominal pain, emesis and absence of stools. The initial diagnosis was a difficult diagnosis because of an intestinal obstruction. By this reason it was decided to perform an exploratory laparotomy where it was found a trichobezoar which was extended over the pylorus. According to literature, Laparotomy is the most successful procedure for the resolution of this disease.

Tratamiento percutáneo de abscesos posquirúrgicos

“…Tradicionalmente, el papel principal lo desempeñaba la re-intervención quirúrgica que, en resumen, podía realizarse mediante: laparotomía o apertura de la cavidad abdominal. Lo que generaba al paciente un trauma quirúrgico importante de la pared, dolor posoperatorio, un aumento de las estancias hospitalarias y mayor número de complicaciones, laparoscopia con lavado exhaustivo de la cavidad y colocación de drenaje Penrose 6,7 . En la actualidad, los avances en radiología como la tomografía computarizada, los ultrasonidos o nuevos materiales de intervención y drenaje han permitido crear y mejorar una técnica de mínima invasión para el tratamiento de estos abscesos de forma percutánea mediante guía de imagen 7,8 .…”