Sinan HATİPOĞLU, Abdullah ATLIHAN, Elmir BAYRAMOĞLU

Dev Gastrik Trikobezoar: Bir Rapunzel Sendromu Olgusu ve Literatür Derleme

ÖzetBezoar, sindirilemeyen yabancı maddelerin yetersiz çiğneme ve öğütme, mide çıkış yolu obstrüksiyonu, mide boşalmasında bozukluk gibi birçok faktör etkisi ile mide ve/veya ince barsakta birikmesi sonucu oluşan bir kitledir.Normalde büyük miktarlarda sindirilemeyen yabancı cisimler gastrointestinal sistemden temizlenebilir. Bezoar oluşumunda, mide ve gastrointestinal sistem anatomi ve fizyolojisindeki değişiklikler ile alınan yabancı maddenin ısrarlı olarak alımı sorumludur. Devamlı olarak alınan yabancı maddeler lifli sebzeler ise fitobezoar, hayvansal yağlar ve kıllar ise trikobezoar veya antiasit gibi ilaçlara bağlı ise farmobezoar denilir. Mide bezoarları sıklıkla mide cerrahisi sonrası oluşmakta olup mide cerrahisi öyküsü bulunmayan kişilerde sıklıkla kendi saçlarını koparmak ve yutmak için dayanılmaz istek duyduğu psikiyatrik problemlerin olduğu trikotilomani bulunur. Gastrik bezoar; enzim kullanımına dayanan medikal yöntemle, endoskopik veya cerrahi müdahale ile tedavi edilebilir. Bu vaka sunumunda, cerrahi olarak tedavi ettiğimiz genç bir bayan hastada mide çıkışında darlığına sebep olmuş bir dev gastrik trikobezoar (Rapunzel Sendromu) vakasını mevcut literatürü gözden geçirerek sunduk.

Anahtar Kelimeler:

Karın ağrısı, bezoarlar, trikobezoar, rapunzel sendromu, trikotillomani

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