Acute Pancreatitis Complicated by Rapunzel Syndrome in a Patient with Incomplete Situs Inversus: A Case Report
Ichrak Bouali
Department of General Surgery, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, University of Hassan II, Casablanca, Morocco.
Ilias EL Azhari *
Department of General Surgery, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, University of Hassan II, Casablanca, Morocco.
Othmane Berrada
Department of General Surgery, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, University of Hassan II, Casablanca, Morocco.
Nassima Fakhiri
Department of General Surgery, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, University of Hassan II, Casablanca, Morocco.
Abdelhak Ettaoussi
Department of General Surgery, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, University of Hassan II, Casablanca, Morocco.
Abdessamad Majd
Department of General Surgery, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, University of Hassan II, Casablanca, Morocco.
Khadija Kamal
Department of General Surgery, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, University of Hassan II, Casablanca, Morocco.
Abdelilah EL Bakouri
Department of General Surgery, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, University of Hassan II, Casablanca, Morocco.
Mounir Bouali
Department of General Surgery, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, University of Hassan II, Casablanca, Morocco.
Khalid EL Hattabi
Department of General Surgery, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, University of Hassan II, Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Background: Situs inversus is a rare anatomical anomaly that renders surgical presentations atypical. The association of acute pancreatitis, a gastrointestinal trichobezoar, and Rapunzel syndrome in a patient with situs inversus is exceptional.
Case Report: We report the case of a 17-year-old female patient with unknown situs inversus who presented with biochemical acute pancreatitis that progressed to multiple digestive perforations associated with gastrointestinal trichobezoars fulfilling the criteria for Rapunzel syndrome.
Conclusion: This case highlights the importance of a thorough and multimodal diagnostic evaluation in the setting of acute abdominal symptoms, and the need to anticipate rare complications — particularly Rapunzel syndrome — in patients with congenital anatomical anomalies.
Keywords: Situs inversus, acute pancreatitis, Trichobezoar, rapunzel syndrome, digestive perforation, surgical emergency