Stomach This: A Novel Type of Gastritis

Atrophic gastritis can be environmental in origin and involve the antrum or autoimmune in origin and involve the body and fundus. We present a rare case of autoimmune atrophic pangastritis (AIAP), a distinct type of autoimmune gastritis (AIG) affecting the entire stomach, which should be considered in patients with other autoimmune disorders.

Dysphagia due to spontaneous hyperinflation of a swallowable intragastric balloon

A 49-year-old woman presented as an acute admission with persistent vomiting and an inability to tolerate both solids and liquids. Five weeks prior to the admission she had an Elipse swallowable intragastric balloon placed into her stomach as an aid to weight loss. This type of balloon stays inflated inside the stomach for 16 weeks before disintegrating and passing through the gastrointestinal tract. Observations and blood parameters were unremarkable but abdominal radiograph indicated that the balloon had undergone spontaneous hyperinflation—a rare complication. At gastroscopy, the balloon was found to fill the entire stomach volume causing dysphagia. The balloon was punctured endoscopically, contents suctioned and remnants retrieved through the gastroscope. The patient commenced oral intake the following day and was discharged home with no further symptoms at 12-week follow-up.

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

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.

Rapunzel syndrome resulting in gastric perforation

We report the case of an 18-year-old female patient with no past medical history who presented to the emergency department with acute abdominal pain and vomiting on the background of a long history of ingesting hair (trichophagia). Computed tomography revealed pneumoperitoneum and free fluid in keeping with visceral perforation. In addition, a large hair bolus was seen extending in contiguity from the stomach to the jejunum. A laparotomy was performed, revealing an anterior gastric perforation secondary to a 120cm long trichobezoar, which had formed a cast of the entire stomach, duodenum and proximal jejunum. The bezoar was removed and an omental patch repair to the anterior ulcer was performed. The patient made an excellent postoperative recovery and was discharged home with psychiatric follow-up review.