Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Infected sinus pilonidalis is common in young patients, causing much discomfort. Up to now, many different therapy options have been described. The aim of this study was to evaluate the longterm results for infected pilonidal sinus disease after primary drainage of the abscess, secondary rhomboid excision, and Limberg flap procedure. ⋯ In infected sinus pilonidalis disease, primary drainage of the abscess by incision, secondary radical rhomboid excision, and the Limberg flap procedure to close the defect can be recommended as a good therapeutic option due to its low complication rate, acceptable long-term results, and simple operative technique.
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Case Reports
[The Rapunzel syndrome: rare manifestation of a trichobezoar of the upper gastrointestinal tract].
The Rapunzel syndrome is a rare manifestation of a gastric trichobezoar with a "tail" extending throughout the small intestine and sometimes even to the colon. We report on the surgical removal of such a bezoar in a 4-year-old patient by gastrotomy--the third published case in the German literature. The syndrome is mainly seen in young girls with trichophagia psychodynamically associated with early childhood deprivation and a high comorbidity of serious pediatric psychiatric disorders. ⋯ The therapy of choice is surgery of the trichobezoar together with the whole intestinal "tail," as in most cases endoscopic removal fails due to the large extension. Early diagnosis and treatment of the Rapunzel syndrome is of eminent importance in order to avoid later fatal complications such as gastric perforation and intestinal necroses. Intensive psychiatric follow-up is mandatory for preventing relapses.