Answer for CoW 10 Sep 2017
Rapunzel syndrome
Findings
Abdominal radiograph distended stomach shadow with an intragastric mottled gas pattern, outlined by fundal gas CT intragastric well-circumscribed inhomogenous mass consisting of ‘mottled gas pattern’ or ‘compressed concentric rings’ pattern normal stomach wall can be traced completely separate from the lesion no contrast enhancement free fluid pelvis.
Discussion
There can be several subtypes depending of the predominant contents: trichobezoar: is a bezoar formed from hair. This has also been called Rapunzel syndrome when the tail of the trichobezoar extends some distance through small bowel. phytobezoar: are composed of indigestible food material (e.g. cellulose) and are frequently reported in patients with impaired digestion and decreased gastric motility. pharmacobezoar: (or medication bezoars) are mostly undigested tablets or semi-liquid masses of drugs. lactobezoar: containing undigested milk curds.
Differential diagnosis gastrointestinal tumour such as a GIST extending into the stomach lumen.
Findings
Abdominal radiograph distended stomach shadow with an intragastric mottled gas pattern, outlined by fundal gas CT intragastric well-circumscribed inhomogenous mass consisting of ‘mottled gas pattern’ or ‘compressed concentric rings’ pattern normal stomach wall can be traced completely separate from the lesion no contrast enhancement free fluid pelvis.
Discussion
There can be several subtypes depending of the predominant contents: trichobezoar: is a bezoar formed from hair. This has also been called Rapunzel syndrome when the tail of the trichobezoar extends some distance through small bowel. phytobezoar: are composed of indigestible food material (e.g. cellulose) and are frequently reported in patients with impaired digestion and decreased gastric motility. pharmacobezoar: (or medication bezoars) are mostly undigested tablets or semi-liquid masses of drugs. lactobezoar: containing undigested milk curds.
Differential diagnosis gastrointestinal tumour such as a GIST extending into the stomach lumen.
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!