Combined Endoscopic-laparoscopic-gastrostomy is a Better Removal Technique of Rapunzel Syndrome A Case Report

Abstract

Introduction: The Rapunzel syndrome (RS) is a trichobezoar that is located in the stomach to the pylorus. Laparotomy-gastrostomy, as a standard treatment, has many risks. The risk of open surgery can be reduced by minimally invasive surgery. Solo endoscopic or laparoscopic is hard and requires a long time for too many trichobezoars. The combination of endoscopic-laparoscopic- gastrostomy removed RS for better results. Method: We reported a 9-year-old female Rapunzel syndrome and was suspected because of trichotillomania and trichophagia. The barium meal and endoscopy confirmed the diagnosis. Surgical removal used combined endoscopic-laparoscopic-gastrostomy, good result, and requiring a shorter time. Result: Four hundred grams of trichobezoar was removed. Six days after surgery, the patient was discharged from the hospital and evaluated for post-operative and psychiatric. Conclusion: Combined endoscopic-laparoscopic-gastroscopy is a better removal technique for Rapunzel Syndrome.