Abstract:
Introduction : Rapunzel syndrome (RS) is an uncommon diagnosis in children with less than 40 cases reported.
Open - laparotomy - gastrostomy, as standard treatment, has many risks, while single endoscopy or laparoscopy
is quite hard to be performed for too many trichobezoars. We present a case of RS treated success fully with
the first combination of endoscopy - laparoscopy - gastrostomy.
Case : A 9 - year - old girl with episodic abdominal pain, recurrent vomiting, anorexia, constipation, non - tender
abdominal enlargement, trichophagia, and trichotillo mania was diagnosed as RS from barium meal and endoscopy examination. We performed combined endoscopy - laparoscopy - gastrostomy to remove 400g of bezoar
mass. The patient had a good out come and a shorter hospital stay.
Conclusion : Combined endoscopy - laparoscopy - gastrostomy provide better treatment of choice in a child with Rapunzel syndrome.
Key messages : Minimal invasive surgery performed through combined endoscopy - laparoscopy - gastrostomy is
the new removal technique for large size trichobezoar.
