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  • Title: Surgical outcome of jejunum-jejunum intussusception secondary to Rapunzel syndrome: a case report.
    Author: Bolívar-Rodríguez MA, Fierro-López R, Pamanes-Lozano A, Cazarez-Aguilar MA, Osuna-Wong BA, Ortiz-Bojórquez JC.
    Journal: J Med Case Rep; 2018 Dec 07; 12(1):362. PubMed ID: 30522519.
    Abstract:
    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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