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Surgical outcome of jejunum-jejunum intussusception secondary to Rapunzel syndrome: a case report
Martín Adrián Bolívar-Rodríguez1, Rodolfo Fierro-López2, Adrián Pamanes-Lozano2
1Departament of General Surgery, Centro de Investigación y Docencia en Ciencias de la Salud de la Universidad Autónoma de Sinaloa en el Hospital Civil de Culiacán, Culiacán, Mexico. bolivarmartin64@hotmail.com.
Background:
Adult intestinal intussusception is a rare condition caused by the mechanical disruption of bowel motility. A bezoar is defined as indigestible material inside the gastrointestinal tract that develops into a trapped mass; the most frequent bezoar is a trichobezoar. When a trichobezoar extends into the small intestine it is defined as Rapunzel's syndrome. Literature describing complications related to this pathology remains scarce.
Case Presentation:
A 16-year-old Mexican girl presented to our emergency room with acute abdomen and a presumptive diagnosis of intestinal obstruction. Computed tomography was suggestive of intussusception. Surgery confirmed a jejunal-jejunal intussusception with a mass within the gastric cavity extending into her small intestine, corresponding to a trichobezoar. A manual intussusception reduction and a gastrotomy with extraction of the trichobezoar were performed.
Conclusions:
We present a case of a jejunum intussusception as a complication of Rapunzel syndrome. Our patient had a favorable outcome after surgical intervention with a manual intussusception reduction, with retrograde displacement of the trichobezoar into the gastric lumen, and a complete extraction through a gastrostomy. Follow-up included psychiatric evaluation.
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