Rapunzel Syndrome—An Extremely Rare Cause of Digestive Symptoms in Children: A Case Report and a Review of the Literature

Rapunzel syndrome is an extremely rare condition seen in adolescents or young females with psychiatric disorders consisting of a gastric trichobezoar with an extension within the small bowel. The delays in diagnosis are common since in its early stages, it is usually asymptomatic. We report the case of a 13-year-old girl admitted in our clinic for abdominal pain, anorexia, and weight loss. The clinical exam pointed out diffuse alopecia, a palpable mass in the epigastric area, and abdominal tenderness at palpation, the patient weighing 32 kg. The laboratory tests showed anemia. The abdominal ultrasound showed a gastric intraluminal mass with a superior hyperechoic arc. The upper digestive endoscopy revealed a mass formed by hair, mucus, and food occupying the gastric cavity with the extension into the duodenum confirming the diagnosis of Rapunzel syndrome. The giant trichobezoar of 511 g, measuring 17 × 7 × 6.5 cm with a tail of approximately 3 cm, was successfully removed through laparotomy. Although rare, Rapunzel syndrome must never be forgotten as a differential diagnosis for digestive symptoms since its early detection hinders the occurrence of further complications.

Gastric Obstruction by Tricobezoar in Cat Associated with Lynxacarus radovskyi: a Case Report

The presence of trichobezoar in cats is characterized by the accumulation of hair in the gastric cavity, which may be associated with the presence of dermatitis caused by the presence of the mite Lynxacarus radovskyi. In the present report, a clinical case of a feline patient with diagnostic and surgical diagnosis of the presence of a trichobezoar with the presence of Lynxacarus radovskyi in a skin scrape examination was described.

Video-Assisted Jejunostomy Tube Placement With Two Portals: Surgical Technique in Ten Steps

Objectives. Endoscopic gastrostomy occasionally presents limitations such as costs, availability of equipment and special materials, and difficult access to the gastric cavity in the setting of obstructive esophageal tumors. Open jejunostomies present high rates of postoperative complications and limited capacity for abdominal evaluation due to reduced incision size. Thus, to reduce procedure-related complications and overall costs and provide a thorough intraoperative evaluation of the peritoneal cavity, we present the following simplified technique. Methods. Video-assisted jejunostomy in ten steps. Results. The use of this Video-assisted laparoscopic technique proves to be a safe, viable alternative, with cost reduction, decreased use of disposable materials, shortened operative time, and accelerated recovery, in addition to increased technical ease and wide applicability across a variety of hospital settings.

An integrated morphological–molecular approach reveals new insights on the systematics of the octocoral Telestula humilis (Thomson, 1927) (Octocorallia:Alcyonacea:Clavulariidae)

Telestula humilis (Thomson, 1927) is a rare deep-sea stoloniferan octocoral distributed in the eastern Atlantic. Here we compared seven putative colonies of this species collected off Spain with the lectotype from the Oceanographic Museum of Monaco and found them to be identical morphologically. Phylogenetic analyses on both full mitogenomes and a concatenated alignment containing two mtDNA genes (mtMutS and Cox1) and nuclear 28S rRNA gene recovered Telestula humilis sister to Incrustatus and Inconstantia rather than to other species of Telestula. This therefore supports its taxonomic reassignment to Pseudotelestula gen. nov. as Pseudotelestula humilis comb. nov. The taxonomic reassignment is also supported by subtle differences observed between the morphology of the colony and the sclerome of Pseudotelestula humilis comb. nov. and the two sister genera. The occurrence of an intrusion tissue with sclerites in the basal part of the gastric cavity of the adult polyps is shared among Telestula and Pseudotelestula gen. nov. However, Pseudotelestula gen. nov. has sclerites arranged in a collaret and points below the tentacles, the sclerites of the calyx wall and the stolon are plump warty spindles, and the intrusion tissue has long sticks and spindles with cone-like spines.

UNANI CONCEPT AND MANAGEMENT OF QAI (NAUSEA) & GHASIYAN (VOMITING)-A REVIEW

According to Unani System of Medicine vomiting can be defined as the movement of stomach for elimination of gastric content through mouth. The matter of vomiting always found in gastric cavity (Jof-e-meda). Renowned unani physicians discussed about Qai and Ghasiyan in detailed, also explained the useful single drugs and compound formulations for treating nausea and vomiting. The only difference between nausea and vomiting is that, in vomiting the matter expel out through mouth, while in nausea it is not expelled. The matter of nausea is found in tissues of stomach and patient feels pain and tenderness in stomach. In this review paper we try to discussed unani concept and management of Nausea and vomiting.

Diagnosis of upper gastrointestinal lesions by endoscopy and its correlation with histopathology

Background: A wide spectrum of lesions can be encountered in the upper gastrointestinal tract (GIT) especially the stomach or the gastric cavity. Endoscopy forms a crucial diagnostic procedure; it gives good diagnostic results in non-neoplastic lesions, endoscopy with biopsy is usually done in neoplastic lesions where the differentiation of benign and malignant lesions cannot be made always. Materials and Methods: This is a retrospective cum prospective study and the duration of this study was 4 yearsfrom January 2015 to December 2019 and the total number of endoscopic procedures performed was 3978. All patients with symptoms pertaining to the upper GIT where Upper Gastro-Intestinal Endoscopy (UGI Endoscopy) is useful in diagnosis were included in this study. All age groups and both the sexes were included. Biopsy was taken wherever there was an indication. Results: In this study, a total of 3978 endoscopies were done, out of which 2689 patients were males (67.6%) and 1289 were females (32.4%), youngest patient age in this study was 13 years and the oldest was 79 years. Most of the lesions were located in the gastric cavity (48% - 1909 cases), followed by esophagus (34%-1353 cases) and least among the three in the duodenum (18%- 716 cases). Out of the 3978 lesions, 134 cases were diagnosed as carcinoma on endoscopy and they were confirmed by histopathological examination. Conclusion: Endoscopy plays a very important role in the diagnosis of upper GIT lesions and it is incomplete without histopathological examination of biopsied tissue in cases of neoplastic lesions