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[20120627. Bezoar (18) - Rapunzel syndrome (2)]

아래는 2003년 NEJM에 소개된 증례입니다 (Lanoue. NEJM 2003;348:1242). 가장 전형적인 Rapunzel syndrome이 아닌가 생각됩니다.

"A four-year-old girl was brought to her pediatrician by her parents because of intermittent bilious emesis, which had started two weeks earlier. There were no other changes in her bowel or bladder habits, and she had not lost weight. Her parents reported that she occasionally pulled at and ate her hair, but they did not believe that this behavior was compulsive or obsessive (trichotillomania). Physical examination revealed a firm mass in the upper abdomen, but the rest of the examination was unremarkable. An upper gastrointestinal series revealed a large trichobezoar in the child's stomach and proximal small bowel (Panel A). At laparotomy, the stomach was tense and filled with a firm mass (Panel B). A gastrotomy was performed, and a large cast-like trichobezoar was removed intact. It had almost completely occluded the stomach, duodenum, and proximal jejunum (Panel C). The child had an essentially uneventful postoperative course and has recovered fully."


1. EndoATLAS 위석 - 위석 총정리