Trichobezoar from bristles brush and Carpet yarn requiring emergency laparotomy. Case report.

INTRODUCTION AND IMPORTANCE: When hair accumulates inside the stomach, it causes what is called a Trichobezoar, which leads to a stomach blockage, this condition is rare and more common in women and in patients with psychiatric disorders. CASE PRESENTATION: The authors report an unusual case of a 16-year-old girl who has trichobezoar not only by ingestion of hair, it is also by bristle clothes brush and Carpet yarn. she presented with acute abdominal pain and gastrointestinal symptoms-like watery diarrhea, vomiting, hypercoria and weight loss attributed to Anorexia. With an upper gastroscopy, the condition was diagnosed as a huge Trichobezoar that occupied the stomach. The patient was managed by surgical removal of the intra gastric mass. CLINICAL DISCUSSION: Affected patients infrequently remain asymptomatic for several years. Symptoms begin while the bezoar increases in size to the point of obstruction, these symptoms are nonspecific like vomiting, nausea, anorexia, asymptomatic abdominal mass and digestive bleeding. CONCLUSION: Trichobezoar considers as a differential diagnosis for any patient with psychological disorders, like trichotillomania and trichophagia and has gastrointestinal symptoms.

Gluteal muscles primary hydatid cyst after cortical bone destruction in the sacrum.

INTRODUCTION: Hydatid disease is caused by infection of Echinococcus Granulosus. Usually Hydatid Cysts occur in the liver and lungs. Presenting hydatid cysts in bone without hepatic affectation is rare and occurs in 0.5-2% of cases. Hence, this rare case makes the diagnosis difficult for the clinicians and, as a result, misdiagnosis of sacral Echinococcosis is common. PRESENTATION OF CASE: The authors report on a 47-year male with primary sacral hydatidosis and 34 years of recurrence. He was admitted with compressive neurological symptoms like tingling pain, numbness, sciatica and foot drop. He has undergone 8 operations and has been treated with Albendazole. He has developed a Sacro-cutaneous fistula. DISCUSSION: When assessing sciatica, low back pain or lower limb weakness the pelvic cavity should be examined for hidden disease that might explain the neurological symptoms. CONCLUSION: A missed diagnosis of osseous Hydatidosis could be devastating. Accordingly, the sacral Hydatid cyst must be included as a differential diagnosis for compressive neurological symptoms. In clinical practice, surgery remains the gold standard for treating osseous Hydatidosis.

Rapunzel Syndrome in Congenital Mental Retardation Patient Requiring Emergency Laparotomy. Case report.

INTRODUCTION: When hair accumulates inside the stomach, it causes what is called a Trichobezoar, which leads to a stomach blockage. When the accumulated hair extends into the small intestine, it causes a rare disturbance called Rapunzel syndrome (RS). DISCUSSION: Affected patients infrequently remain asymptomatic for several years. Symptoms begin while the bezoar increases in size to the point of obstruction, these symptoms are nonspecific like vomiting, nausea, anorexia, asymptomatic abdominal mass and digestive bleeding. PRESENTATION OF CASE: The authors report an unusual case of a 25 years old young woman who presented with acute abdominal pain and gastrointestinal symptoms. With an upper gastroscopy, the condition was first diagnosed as a Trichobezoar that occupied the stomach. A decision to perform a surgical procedure was taken, only to discover, during the procedure, that the mass was extended to the duodenum and jejunum, thus diagnosing the condition as Rapunzel syndrome. The patient was managed by surgical removal of the huge mass. CONCLUSION: Trichobezoar considers as a differential diagnosis for any patient with mental retardation and has gastrointestinal symptoms.

Bloom syndrome with myelodysplastic syndrome that was converted into acute myeloid leukaemia, with new ophthalmologic manifestations: the first report from Syria.

Bloom syndrome is a rare autosomal recessive disease, in which BLM gene is mutated, leading to genome instability and proneness to malignancy. It is characterized by short stature, sun-sensitive rash and immunodeficiency. We present a case of bloom syndrome with myelodysplasia complicated by acute myeloid leukaemia. This case has new ophthalmologic manifestations. We confirmed the diagnosis by detection of high rate of sister chromatid exchange. The patient received chemotherapy but did not tolerate it well and developed fungal pneumonia.