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Surgical outcome of jejunum-jejunum intussusception secondary to Rapunzel syndrome: a case report.
J Med Case Rep 2018; 12(1):362JM

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.

Authors+Show Affiliations

Departament 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.Departament 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.Departament 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.Departament 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.Departament 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.Departament 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.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

30522519

Citation

Bolívar-Rodríguez, Martín Adrián, et al. "Surgical Outcome of Jejunum-jejunum Intussusception Secondary to Rapunzel Syndrome: a Case Report." Journal of Medical Case Reports, vol. 12, no. 1, 2018, p. 362.
Bolívar-Rodríguez MA, Fierro-López R, Pamanes-Lozano A, et al. Surgical outcome of jejunum-jejunum intussusception secondary to Rapunzel syndrome: a case report. J Med Case Rep. 2018;12(1):362.
Bolívar-Rodríguez, M. A., Fierro-López, R., Pamanes-Lozano, A., Cazarez-Aguilar, M. A., Osuna-Wong, B. A., & Ortiz-Bojórquez, J. C. (2018). Surgical outcome of jejunum-jejunum intussusception secondary to Rapunzel syndrome: a case report. Journal of Medical Case Reports, 12(1), p. 362. doi:10.1186/s13256-018-1883-9.
Bolívar-Rodríguez MA, et al. Surgical Outcome of Jejunum-jejunum Intussusception Secondary to Rapunzel Syndrome: a Case Report. J Med Case Rep. 2018 Dec 7;12(1):362. PubMed PMID: 30522519.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical outcome of jejunum-jejunum intussusception secondary to Rapunzel syndrome: a case report. AU - Bolívar-Rodríguez,Martín Adrián, AU - Fierro-López,Rodolfo, AU - Pamanes-Lozano,Adrián, AU - Cazarez-Aguilar,Marcel Antonio, AU - Osuna-Wong,Benny Alonso, AU - Ortiz-Bojórquez,José Cándido, Y1 - 2018/12/07/ PY - 2017/10/17/received PY - 2018/10/16/accepted PY - 2018/12/8/entrez PY - 2018/12/14/pubmed PY - 2019/4/9/medline KW - Gastrotomy KW - Intestinal intussusception KW - Rapunzel syndrome KW - Trichobezoar SP - 362 EP - 362 JF - Journal of medical case reports JO - J Med Case Rep VL - 12 IS - 1 N2 - 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. SN - 1752-1947 UR - https://www.unboundmedicine.com/medline/citation/30522519/Surgical_outcome_of_jejunum_jejunum_intussusception_secondary_to_Rapunzel_syndrome:_a_case_report_ L2 - https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-018-1883-9 DB - PRIME DP - Unbound Medicine ER -