<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1405-0099</journal-id>
<journal-title><![CDATA[Cirujano general]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. gen]]></abbrev-journal-title>
<issn>1405-0099</issn>
<publisher>
<publisher-name><![CDATA[Asociación Mexicana de Cirugía General A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1405-00992019000300217</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Síndrome de Rapunzel con doble tricobezoar. Reporte de caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Rapunzel syndrome with double trichobezoar. Clinical case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pliego-Ochoa]]></surname>
<given-names><![CDATA[Adrián Dersu]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Escalante-Ayuso]]></surname>
<given-names><![CDATA[Eduardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mendez-Pérez]]></surname>
<given-names><![CDATA[Edgar Rafael]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General &#8220;Dr. Agustín O&#8217;Horan&#8221; Servicio de Cirugía General ]]></institution>
<addr-line><![CDATA[Mérida Yucatán]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital General &#8220;Dr. Agustín O&#8217;Horan&#8221; Servicio de Cirugía General ]]></institution>
<addr-line><![CDATA[Mérida Yucatán]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2019</year>
</pub-date>
<volume>41</volume>
<numero>3</numero>
<fpage>217</fpage>
<lpage>220</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1405-00992019000300217&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1405-00992019000300217&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1405-00992019000300217&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  El síndrome de Rapunzel es una entidad no frecuente que consiste en un tricobezoar gástrico con extensión a duodeno acompañado de síntomas de oclusión intestinal, aumentando los riesgos de complicaciones como perforación y peritonitis.  Caso clínico:  Femenino de 15 años con cuadro clínico de dolor abdominal de dos semanas de evolución, asociado a náuseas, emesis, saciedad temprana y disminución en la consistencia de las evacuaciones. Refiere hábitos de tricotilomanía y tricofagia de un año de evolución. A la exploración física, abdomen distendido con peristalsis disminuida y sin datos de irritación peritoneal. En los estudios de imagen se observa una masa ocupativa en el estómago y primera porción del duodeno, así como niveles hidroaéreos. Se realiza manejo quirúrgico mediante laparotomía encontrando un tricobezoar gástrico, además de otro en yeyuno, efectuándose la extracción completa mediante gastrotomía y enterotomía. Se inició la dieta enteral a las 72 horas y es egresada del servicio al séptimo día del postoperatorio.  Conclusión:  Los bezoares se pueden resolver por métodos no quirúrgicos; sin embargo, se debe valorar el estado hemodinámico del paciente; se recomienda el manejo quirúrgico con buenos resultados. Es necesario un manejo multidisciplinario con este tipo de pacientes para prevenir su recurrencia.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  Rapunzel syndrome is a rare entity that consists of a gastric trichobezoar with extension to the duodenum and accompanied by symptoms of intestinal occlusion, increasing the risk of complications such as perforation and peritonitis.  Case report:  A 15-year-old female with a clinical of abdominal pain of two weeks of evolution, associated with nausea, emesis, early satiety and a decrease in the consistency of the stools. It refers to trichotillomania and trichophagia habits of one year of evolution. On physical examination, distended abdomen with decreased peristalsis and no evidence of peritoneal irritation. Imaging studies show an occupational mass in the stomach and first portion of the duodenum, as well as hydro-aerial levels. Surgical management was performed by laparotomy, finding a gastric trichobezoar in addition to another one in the jejunum, performing the complete extraction through gastrotomy and enterotomy. Enteral diet started at 72 hrs. And is a graduate of the service on the seventh day of the postoperative period.  Conclusion:  Bezoars can be resolved by non-surgical methods; however, the patient&#8217;s hemodynamic status should be assessed; surgical management is recommended with good results. Multidisciplinary management with this type of patients is necessary to prevent recurrence.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Bezoares/patología]]></kwd>
<kwd lng="es"><![CDATA[bezoares/cirugía]]></kwd>
<kwd lng="es"><![CDATA[tricobezoar]]></kwd>
<kwd lng="es"><![CDATA[obstrucción intestinal/etiología]]></kwd>
<kwd lng="es"><![CDATA[gastrostomía/métodos]]></kwd>
<kwd lng="es"><![CDATA[tricotilomanía/complicaciones]]></kwd>
<kwd lng="en"><![CDATA[Bezoars/pathology]]></kwd>
<kwd lng="en"><![CDATA[bezoars/surgery]]></kwd>
<kwd lng="en"><![CDATA[trichobezoar]]></kwd>
<kwd lng="en"><![CDATA[intestinal obstruction/etiology]]></kwd>
<kwd lng="en"><![CDATA[gastrostomy/methods]]></kwd>
<kwd lng="en"><![CDATA[trichotillomania /complications]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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