scholarly journals Rapunzel syndrome

2012 ◽  
Vol 69 (8) ◽  
pp. 717-720 ◽  
Author(s):  
Gordana Petrovic ◽  
Aleksandar Nagorni ◽  
Goran Bjelakovic ◽  
Daniela Benedeto-Stojanov ◽  
Biljana Radovanovic-Dinic ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Foreign Bodies ◽  
Psychiatric Treatment ◽  
Abdominal Mass ◽  
Rare Form ◽  
Rapunzel Syndrome ◽  
Younger Women ◽  
Palpable Abdominal Mass ◽  
Over Time

Introduction. Trichobezoars are foreign bodies in gastrointestinal tract, composed of hair. They occur mainly in children and adolescents suffering from trichotillophagia. They commonly occur in the stomach, but as they enlarge over time, they can extend through the pylorus into distal parts of the small intestine resembling a tail. This rare form of trichobezoar is named Rapunzel syndrome. Case report. We presented a 19-year-old female patient, who suffered from trichotillomania and trichotillophagia, which led to trichobezoar formation. Intra-abdominal tumour was suspected after initial clinical examination. Abdominal echosonography, endoscopy and abdominal computed tomography (CT scan) in the pre-operational period revealed trichobezoar formation. The patient was operated on and subjected to further psychiatric treatment. Conclusion. Trichobezoar should be differentially diagnostically taken into consideration in younger women with abdominal pain, nausea, vomiting, palpable abdominal mass and psychiatric disorders. Most trichobezoar cases require surgical treatment, whereas the patients need long-term psychiatric treatment and monitoring.

scholarly journals Unusual Presentation of Rapunzel Syndrome in an 8-Year-Old Girl

2020 ◽  
Vol 7 (12) ◽  
pp. 5139-5143
Author(s):  
Alaa H Rostom MD ◽  
Mohammed S Alisi MD ◽  
Mai M Akila MD
Keyword(s):  
Hair Loss ◽  
Fairy Tale ◽  
Abdominal Mass ◽  
Rapunzel Syndrome ◽  
Long Tail ◽  
Case Presentation ◽  
Long Term Follow Up ◽  
Palpable Abdominal Mass

Introduction: Trichobezoar is a rare clinical entity in which a ball of hair accumulates within the alimentary tract. It can be found as an isolated mass in the stomach or may extend into the duodenum and jejunum, which is labeled as Rapunzel syndrome. In this article, we report a rare case of Rapunzel syndrome with a long tail that presented with non-specific features. Case Presentation: An 8-year-old female patient was referred to our clinic due to palpable abdominal mass. Physical examination revealed non-tender, well-defined abdominal mass and signs of anemia. Imaging showed a giant bezoar filling the stomach, duodenum, and part of jejunum without features of mechanical obstruction. Laparotomy revealed large trichobezoar with long tail. Retrospective evaluation showed significant hair loss and frequent habit of trichotillomania and trichophagia. Conclusion: Rapunzel Syndrome is not a fairy tale. It may present with vague non-obstructing features. Significant hair loss and underlying psychiatric disorders should raise suspicion to do further investigations. Long-term follow-up and psychiatric management are recommended to prevent recurrence.

Computed tomography in 101 patients with a palpable abdominal mass

1984 ◽  
Vol 35 (4) ◽  
pp. 293-296 ◽  
Author(s):  
M.P. Williams ◽  
I.H.K. Scott ◽  
A.K. Dixon
Keyword(s):  
Computed Tomography ◽  
Abdominal Mass ◽  
Palpable Abdominal Mass

scholarly journals Sex differences in coronary plaque changes assessed by serial computed tomography angiography

2021 ◽  
Author(s):  
Mohammed El Mahdiui ◽  
Jeff M. Smit ◽  
Alexander R. van Rosendael ◽  
Danilo Neglia ◽  
Juhani Knuuti ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Sex Differences ◽  
Computed Tomography Angiography ◽  
Coronary Plaque ◽  
Intermediate Risk ◽  
Plaque Progression ◽  
Coronary Cta ◽  
Over Time

AbstractLong-term data on sex-differences in coronary plaque changes over time is lacking in a low-to-intermediate risk population of stable coronary artery disease (CAD). The aim of this study was to evaluate the role of sex on long-term plaque progression and evolution of plaque composition. Furthermore, the influence of menopause on plaque progression and composition was also evaluated. Patients that underwent a coronary computed tomography angiography (CTA) were prospectively included to undergo a follow-up coronary CTA. Total and compositional plaque volumes were normalized using the vessel volume to calculate a percentage atheroma volume (PAV). To investigate the influence of menopause on plaque progression, patients were divided into two groups, under and over 55 years of age. In total, 211 patients were included in this analysis, 146 (69%) men. The mean interscan period between baseline and follow-up coronary CTA was 6.2 ± 1.4 years. Women were older, had higher HDL levels and presented more often with atypical chest pain. Men had 434 plaque sites and women 156. On a per-lesion analysis, women had less fibro-fatty PAV compared to men (β -1.3 ± 0.4%; p < 0.001), with no other significant differences. When stratifying patients by 55 years age threshold, fibro-fatty PAV remained higher in men in both age groups (p < 0.05) whilst women younger than 55 years demonstrated more regression of fibrous (β -0.8 ± 0.3% per year; p = 0.002) and non-calcified PAV (β -0.7 ± 0.3% per year; p = 0.027). In a low-to-intermediate risk population of stable CAD patients, no significant sex differences in total PAV increase over time were observed. Fibro-fatty PAV was lower in women at any age and women under 55 years demonstrated significantly greater reduction in fibrous and non-calcified PAV over time compared to age-matched men. (ClinicalTrials.gov number, NCT04448691.)

scholarly journals Coexistence xanthogranulomatous pyelonephritis with renal replacement lipomatosis. Computed tomography. Сlinical case

2018 ◽  
pp. 65-72
Author(s):  
Yu. A. Abovich ◽  
O. A. Afukova ◽  
A. L. Yudin
Keyword(s):  
Computed Tomography ◽  
Adipose Tissue ◽  
Rare Disease ◽  
Postoperative Period ◽  
Clinical Manifestations ◽  
Xanthogranulomatous Pyelonephritis ◽  
Rare Form ◽  
Renal Sinus ◽  
Granulomatous Tissue

Xanthogranulomatous pyelonephritis is a relatively rare form of chronic pyelonephritis. It is characterized by combination of destructive and proliferative processes with proliferation in the kidney of granulomatous tissue with a large number of lipid-containing macrophages, which are called xanthomous or "foamy" cells. Replacement kidney lipomatosis is also a rare disease that is characterized by proliferation of adipose tissue of the kidney sinus and perirenal adipose tissue with pronounced atrophy of the renal parenchyma. This is the result of renal atrophy, chronic inflammation, nephrolithiasis or long-term current hydronephrosis with the proliferation of adipose tissue in the renal sinus and paranephric fiber. The article presents a case of combining the above-mentioned pathological processes in a patient of the 93-ies. According to clinical manifestations and examination data, xanthogranulomatous pyelonephritis can occur under the guise of pionephrosis, carbuncle, abscess. Deservedly this disease is called "great imitator", because today there are no clear diagnostic criteria, and the diagnosis is established, as a rule, in the postoperative period.

scholarly journals Unusual trichobezor of stomach and intestines as a manifestation of Rapunzel syndrome: a rare case report

2019 ◽  
Vol 6 (12) ◽  
pp. 4569
Author(s):  
Tejinder Pal Singh Sodhi ◽  
Sameer Pundeer ◽  
Maneshwar Singh Utaal ◽  
Kirti Savyasacchi Goyal
Keyword(s):  
Computed Tomography ◽  
Rare Case ◽  
Proximal Jejunum ◽  
Rare Form ◽  
Rapunzel Syndrome ◽  
Contrast Enhanced ◽  
Rare Case Report ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography ◽  
Entire Stomach

Rapunzel syndrome is a rare form of trichobezoar with accumulation of large amounts of hair extending from stomach to variable portion of small intestine. An 18 year old girl was brought to surgery opd with complaints of vomiting on and off since 3 months. Contrast enhanced computed tomography abdomen showed a bezoar extending from stomach into the duodenum and proximal jejunum suggestive of Rapunzel syndrome with 3rd and 4th part of duodenum along with duodenojejunal junction. On laparotomy, a trichobezoar occupying the entire stomach measured 100 cm in length and 700 grams in weight. Since the mass formed in Rapunzel syndrome is generally too large to be removed endoscopically or laparoscopically, it requires removal by open gastrostomy. 

scholarly journals Evaluation of the long-term effect of polyhexamethylene guanidine phosphate in a rat lung model using conventional chest computed tomography with histopathologic analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256756
Author(s):  
Cherry Kim ◽  
Sang Hoon Jeong ◽  
Jaeyoung Kim ◽  
Ja Young Kang ◽  
Yoon Jeong Nam ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Rat Model ◽  
Chest Ct ◽  
P Value ◽  
Chest Computed Tomography ◽  
Polyhexamethylene Guanidine ◽  
Histopathologic Analysis ◽  
Guanidine Phosphate ◽  
Over Time

There have been no studies on the effects of polyhexamethylene guanidine phosphate (PHMG) after a long period of exposure in the rodent model. We aimed to evaluate long-term lung damage after PHMG exposure using conventional chest computed tomography (CT) and histopathologic analysis in a rat model. A PHMG solution was intratracheally administrated to 24 male rats. At 8, 26, and 52 weeks after PHMG instillation, conventional chest CT was performed in all rats and both lungs were extracted for histopathologic evaluation. At 52 weeks after PHMG instillation, four carcinomas had developed in three of the eight rats (37.5%). Bronchiolo-alveolar hyperplasia and adenoma were found in rats at 8, 26, and 52 weeks post-instillation. The number of bronchiolo-alveolar hyperplasia significantly increased over time (P-value for trend< 0.001). The severity of lung fibrosis and fibrosis scores significantly increased over time (P-values for trend = 0.002 and 0.023, respectively). Conventional chest CT analysis showed that bronchiectasis and linear density scores suggestive of fibrosis significantly increased over time (P-value for trend < 0.001). Our study revealed that one instillation of PHMG in a rat model resulted in lung carcinomas and progressive and irreversible fibrosis one year later based on conventional chest CT and histopathologic analysis. PHMG may be a lung carcinogen in the rat model.

Suicide Attempts During Adolescence: Systematic Hospitalization and Crisis Treatment

Crisis ◽  
1999 ◽  
Vol 20 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Jérôme Ottino
Keyword(s):  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Treatment ◽  
Health Workers ◽  
Inpatient Unit ◽  
Theoretical Hypothesis ◽  
Initial Resistance ◽  
Provision Of Care ◽  
Suicidal Crisis

This paper deals with an inpatient unit that recently opened in Geneva, specializing in the treatment of patients aged 16-21 years who had attempted suicide or felt the desire to commit suicide. This particular center was established because of the significant weaknesses found in the provision of care to adolescents who had attempted suicide. Despite the growing interest of health workers in this area of study over recent years, the frequency of suicide among the young has not decreased and there are numerous recurrences of the suicide attempts. Further, all efforts to improve the adolescents' compliance with psychiatric treatment have failed to date. The number of drop-outs from treatment is still very high. Thus, the objectives of our inpatient unit are as follows: (1) to overcome initial resistance to treatment and to improve long-term compliance; (2) to decrease the number of recurrent attempts as a consequence of the above, thus increasing life expectancy; (3) to offer the adolescents who have tried (or have contemplated) committing suicide an improved quality of life, after first helping them overcome the suicidal crisis. To achieve these goals, the therapeutic team of the unit proposes short stays during which the work with the adolescents consists of a very intensive psychoanalytic-oriented crisis intervention. Numerous practical aspects of our therapeutic approach in the inpatient unit are related here in detail, always with reference to our theoretical hypothesis.

Enhancing community welfare through improved water quality: a case for applying staggered pollution charges in the river Musi sub-basin of Andhra Pradesh, India

Water Policy ◽  
2005 ◽  
Vol 7 (5) ◽  
pp. 469-483
Author(s):  
Tishya Chatterjee
Keyword(s):  
Andhra Pradesh ◽  
Relevant Literature ◽  
Pollution Prevention ◽  
Economic Benefits ◽  
Environmental Damage ◽  
Marginal Costs ◽  
Community Acceptance ◽  
Level Data ◽  
Over Time

In conditions of severe water-pollution and dormant community acceptance of accumulating environmental damage, the regulator's role goes beyond pollution prevention and more towards remediation and solutions based on the community's long-term expectations of economic benefits from clean water. This paper suggests a method to enable these benefits to become perceptible progressively, through participatory clean-up operations, supported by staggered pollution charges. It analyses the relevant literature on pollution prevention and applies a cost-based “willingness to pay” model, using primary basin-level data of total marginal costs. It develops a replicable demand-side approach imposing charge-standard targets over time in urban-industrial basins of developing countries.

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