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Rapunzel syndrome - a case report

100%

Stojanovic M., Slavkovic A., Marjanovic Z., Stojanovic M., Zivanovic D.

Open Medicine

2010

vol. 5

issue 3

354-357

Bezoars are collections of indigestible materials found in the gastrointestinal tract. Rapunzel syndrome is a rare complication of a gastric trichobezoar in which the mass of hair extends through the pylorus into the small bowel and can even reach the colon. A 12-year-old girl with severe pain and a feeling of “fullness” in the upper abdomen was admitted to Pediatric Surgery. Two days before admission, the patient presented with vague abdominal pain, vomiting with a little blood, and black stool. On physical examination she was pale and listless with patchy alopecia. Abdominal examination showed a mobile, palpable mass in the epigastrium. The initial hematocrit was 7,1%, and the erythrocyte count was 1,12×1012 cells per liter. Abdominal ultrasound and computed tomographic (CT) examinations confirmed the presence of a tumor-like formation in stomach. A giant bezoar with ulceration on the back wall of the stomach was verified by upper gastrointestinal endoscopy. Endoscopic extraction was not possible because of the size of the bezoar. Gastrotomy was performed to remove the bezoar that occupied most of the stomach, with a long tail that extended deeply into the duodenum (Rapunzel syndrome). The bezoar, 35 by 10 cm in diameter, was black and consisted of hair and synthetic fibers. Prompt diagnosis and treatment of trichobezoars are important to avoid a possible fatal outcome.

Polish Consensus on Treatment of Gastric Cancer; update 2017

63%

Kulig J., Wallner G., Drews M., Frączek M., Jeziorski A., Kielan W., Kołodziejczyk P., Nasierowska-Guttmejer A., Starzyńska T., Zinkiewicz K., Wojtukiewicz M., Tomasz S. W., Richter P., Krawczyk M.

Polish Journal of Surgery

2017

vol. 89(5)

59-73

The “Polish Research on Gastric Cancer” project has been continued since 1986. The main aim of this project, which is a multicenter and interdisciplinary research, is enhancing the treatment results of gastric cancer patients by developing and promoting the use of optimal methods for diagnosis and treatment, both surgical as well as combined. One of the more important achievements of the project is the development and publication of a document named “Polish Consensus on Treatment of Patients with Gastric Cancer”, whose first version was published in 1998. Following versions were updated adequately to changing trends in the proceedings in patients with gastric cancer. A scientific symposium on “Polish Consensus on Treatment of Gastric Cancer – update 2016” was held in 3-4 June 2016 in Cracow. During the symposium a panel session was held during which all authors publicly presented the Consensus assumptions to be discussed further. Moreover, the already mentioned session was preceded by a correspondence as well as a working meeting in order to consolidate the position. It has to be underlined that the directions and guidelines included in the Consensus are not the arbitrarily assumed rules of conduct in a legal aspect and as such every doctor/team of doctors is entitled to make different decisions as long as they are beneficial to a patient with gastric cancer. The Consensus discusses as follows: a) recommended qualifications (stage of advancement, pathological, lymph node topography and the extent of lymphadenectomy, division of cancer of the gastroesophageal junction), b) rules for diagnostics including recommendations regarding endoscopic examination and clinical evaluation of the advancement stage, c) recommendations regarding surgical treatment (extent of resection, extent of lymphadenectomy, tactics of proceedings in cancer of the gastroesophageal junction), d) recommendations regarding combined treatment with chemotherapy or radiotherapy, e) place of endoscopic and less invasive surgery in the treatment of gastric cancer. This publication is a summary of the arrangements made in the panel session during the abovementioned scientific symposium in Cracow in 2016.

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1 Open Medicine

1 Polish Journal of Surgery

1 2017

1 2010

1 Drews M.

1 Frączek M.

1 Jeziorski A.

1 Kielan W.

1 Kołodziejczyk P.

1 Krawczyk M.

1 Kulig J.

1 Marjanovic Z.

1 Nasierowska-Guttmejer A.

1 Richter P.

1 Slavkovic A.

1 Starzyńska T.

1 Stojanovic M.

1 Tomasz S. W.

1 Wallner G.

1 Wojtukiewicz M.

1 Zinkiewicz K.

1 Zivanovic D.

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Rapunzel syndrome - a case report

Polish Consensus on Treatment of Gastric Cancer; update 2017