<?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>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022025000200093</article-id>
<article-id pub-id-type="doi">10.51481/amc.v67i2.1474</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Síndrome de Rapunzel: causa de suboclusión intestinal en una adolescente. Reporte de caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Rapunzel syndrome: cause of intestinal subobstruction in a teenager. Case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ordóñez]]></surname>
<given-names><![CDATA[Arlin]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez-Sierra]]></surname>
<given-names><![CDATA[Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mejía Escobar]]></surname>
<given-names><![CDATA[Cinthya]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Escuela Servicio de Cirugía Pediátrica ]]></institution>
<addr-line><![CDATA[ Tegucigalpa]]></addr-line>
<country>Honduras</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Nacional Autónoma de Honduras Facultad de Ciencias Médicas ]]></institution>
<addr-line><![CDATA[ Tegucigalpa]]></addr-line>
<country>Honduras</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Escuela Departamento de Gestión Académica e Investigación ]]></institution>
<addr-line><![CDATA[ Tegucigalpa]]></addr-line>
<country>Honduras</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2025</year>
</pub-date>
<volume>67</volume>
<numero>2</numero>
<fpage>93</fpage>
<lpage>97</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022025000200093&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022025000200093&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022025000200093&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 forma rara de tricobezoar, causado por la tricofagia, generalmente asociada a la tricotilomanía. Los tricobezoares están compuestos por cabello ingerido y pueden localizarse en cualquier parte del tracto gastrointestinal, con mayor frecuencia en el estómago. En algunos casos, se extienden hacia el intestino delgado a través del píloro, como ocurre en el síndrome de Rapunzel. Presentamos el caso de una adolescente con diagnóstico de síndrome de Rapunzel y antecedentes psiquiátricos. Paciente femenina de 14 años con antecedentes de ansiedad, depresión, tricotilomanía y tricofagia. Consultó por dolor abdominal crónico, náuseas, vómitos posprandiales e hiporexia, con pérdida ponderal significativa. Al examen físico se identificó masa epigástrica dolorosa. La tomografía computarizada mostró masa intraluminal desde el estómago hasta el duodeno. La endoscopia confirmó la presencia de un tricobezoar. Se realizó laparotomía exploratoria y extracción quirúrgica de una masa de 36 cm de longitud. La paciente evolucionó favorablemente y fue seguida por un equipo multidisciplinario. Conclusión: El síndrome de Rapunzel debe sospecharse en pacientes con síntomas digestivos inespecíficos y antecedentes de trastornos del estado de ánimo. El tratamiento quirúrgico, junto al abordaje psiquiátrico y multidisciplinario, es esencial para prevenir complicaciones y recurrencias. El diagnóstico temprano mejora significativamente el pronóstico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Introduction: Rapunzel Syndrome is a rare type of trichobezoar caused by trichophagia, often associated with trichotillomania. Trichobezoars are masses composed of ingested hair, most commonly located in the stomach, and may extend into the small intestine through the pylorus in RS cases. We present the case of an adolescent diagnosed with Rapunzel Syndrome and a psychiatric history. A 14-year-old female with a history of anxiety, depression, trichotillomania, and trichophagia presented with chronic abdominal pain, postprandial nausea and vomiting, hyporexia, and significant weight loss. On physical examination, a painful epigastric mass was palpated. Abdominal computed tomography revealed an intraluminal mass extending from the stomach to the duodenum. Upper gastrointestinal endoscopy confirmed a trichobezoar. Exploratory laparotomy and surgical extraction of a 36 cm mass were performed. The patient had a favorable postoperative course and received multidisciplinary follow-up. Conclusion: Rapunzel Syndrome should be suspected in patients with nonspecific gastrointestinal symptoms and a psychiatric history. Surgical treatment, combined with psychiatric and multidisciplinary care, is essential to prevent complications and recurrence. Early diagnosis is crucial for improving prognosis.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[síndrome]]></kwd>
<kwd lng="es"><![CDATA[tricotilomanía]]></kwd>
<kwd lng="es"><![CDATA[ansiedad]]></kwd>
<kwd lng="es"><![CDATA[cabello]]></kwd>
<kwd lng="es"><![CDATA[bezoares.]]></kwd>
<kwd lng="en"><![CDATA[Syndrome]]></kwd>
<kwd lng="en"><![CDATA[trichotillomania]]></kwd>
<kwd lng="en"><![CDATA[anxiety]]></kwd>
<kwd lng="en"><![CDATA[hair]]></kwd>
<kwd lng="en"><![CDATA[bezoars]]></kwd>
</kwd-group>
</article-meta>
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