PMC2846351_01
Endoscopic image of a trichobezoar extending into the pylorus.
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A second endoscopy of the upper digestive tract was performed as part of the preoperative work-up, findings revealing a blackened, voluminous mass composed of strands of hair, fibrin and food residue in the stomach, located in the antrum and low body, extending towards the pylorus and blocking passage of the endoscope (Figures 1 and 2).
Endoscopic image of an intragastric trichobezoar.
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fig2
A second endoscopy of the upper digestive tract was performed as part of the preoperative work-up, findings revealing a blackened, voluminous mass composed of strands of hair, fibrin and food residue in the stomach, located in the antrum and low body, extending towards the pylorus and blocking passage of the endoscope (Figures 1 and 2).
Tomography image of a trichobezoar in the stomach.
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A computed tomography scan of the abdomen was also performed and, in addition to identifying a hypodense intragastric mass, results showed hypodense circular areas in the small bowel and the presence of bowel intussusception (Figures 3 and 4), findings compatible with the Rapunzel syndrome.
Tomography image of bowel invagination (arrow).
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fig4
A computed tomography scan of the abdomen was also performed and, in addition to identifying a hypodense intragastric mass, results showed hypodense circular areas in the small bowel and the presence of bowel intussusception (Figures 3 and 4), findings compatible with the Rapunzel syndrome.
Trichobezoar and strands of 1.6 meters in length removed at surgery.
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Gastrotomy was performed and the trichobezoar was removed together with strands in the shape of the stomach and the first portion of the duodenum, extending through the small intestine to a total length of 1.6 meters (Figure 5). 