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Korean J Gastroenterol  <  Volume 74(1); 2019 <  Articles

Korean J Gastroenterol 2019; 74(1): 42-45  https://doi.org/10.4166/kjg.2019.74.1.42
Rapunzel Syndrome Removed with Enteroscopy in a Child
Sang Woo Chun, Kunsong Lee , Youn Joon Park1 and Hyun Deok Shin2
Departments of Pediatrics, Pediatric Surgery1 and Internal Medicine2, Dankook University College of Medicine, Cheonan, Korea
Correspondence to: Kunsong Lee, Department of Pediatrics, Dankook University College of Medicine, 201 Manghyang-ro, Dongnam-gu, Cheonan 31116, Korea. Tel: +82-41-550-3968, Fax: +82-41-550-3949, E-mail: pdlks@dankook.ac.kr, ORCID: https://orcid.org/0000-0001-7318-2296
Received: March 11, 2019; Revised: April 21, 2019; Accepted: April 29, 2019; Published online: July 25, 2019.
© The Korean Journal of Gastroenterology. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
A trichobezoar is a type of bezoar that is composed of hair. In most cases, it is confined to the stomach, but in rare cases, it may extend to the small intestine. This condition is referred to as Rapunzel syndrome. The therapeutic method for bezoar removal depends on its type, location, and size. Generally, the treatment for Rapunzel syndrome involves surgical laparotomy. Endoscopic removal has also been effective in some cases. On the other hand, complications, such as respiratory difficulty and esophageal impaction may be encountered during endoscopic removal. Until now, the successful endoscopic removal of trichobezoars has been limited to the stomach or duodenum. This paper reports the case of a 4-year-old female patient with Rapunzel syndrome whose trichobezoar reached the proximal jejunum. The trichobezoar was removed without complications using an electrosurgical knife and snare through a single-balloon enteroscopy. The trichobezoar can be removed successfully using enteroscopy under general anesthesia without abdominal laparotomy in young children. Therefore, this method of removal can be considered preferentially for children with Rapunzel syndrome.
Keywords: Bezoars; Single-balloon enteroscopy; Child


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