Tricobezoar gástrico: relato de caso e revisão da literatura

Abstract

Bezoar é a impactação de material estranho no interior do trato digestivo, originado a partir da ingestão de diversas substâncias, incluindo cabelos ou pêlos, fibras vegetais e outros. No presente estudo relata-se caso de um volumoso tricobezoar gástrico observado em uma adolescente de 16 anos, com queixa de dor e tumoração palpável na região epigástrica, diagnosticado através da endoscopia digestiva alta. Dada às proporções do bezoar, a paciente foi submetida à gastrotomia anterior com retirada de uma massa sólida de cabelos, com 1200 g, a qual moldava todo o estômago, desde o fundo até o piloro. Uma grande úlcera de pressão também foi detectada em região antral, cujas biópsias revelaram- se negativas para neoplasia. Após a alta, sem intercorrências, a paciente foi encaminhada ao Serviço de Neuropsiquiatria para o tratamento da tricofagia e prevenção da recorrência, objetivo final, ao nosso ver, de todo o tratamento.<br>Bezoar is an impaction of swallowed foreign material into the digestive tract. It is formed from several substances included hairs of humans or animals, vegetable matters and others. At present study the authors report a case of a voluminous gastric trichobezoar observed in a 16-yr-old adolescent with abdominal pain and palpated mass in the epigastrium. Trichobezoar was diagnosed throughout fiberoptic gastroscopy and laparotomy was indicated due to exaggerated size of the mass. Anterior gastrotomy was performed and a solid mass of hairs weighting 1200 g was removed. The removed mass occupied the whole stomach from fundus to pylorus. A big pression ulcer was also detected in the antrum. Biopsies of this ulcer showed to be negatives for neoplasy. There were no complications in postoperative recovery. After discharge the patient was referred to the Neuropsychiatric Service for treatment of trichophagia and prevention of recurrence, in our point of view, the main purpose of all treatment

Intestinal obstruction caused by phytobezoar composed of jaboticaba seeds: case report and literature review

“…Benzoars should be preferably treated using conservative methods 15 . In the case reported in this study, the conservative method successfully eliminated the problem.…”

Tricobezoar gástrico: relato de caso

“…B ezoars are impacted foreign bodies in the digestive tract, resulting from their ingestion and accumulation, primarily affecting the stomack 1 . In females 90% are trichobezoars, usually resulting from trichotillomania 2,3 .…”

“…CT is the most accurate imaging test to demonstrate bezoars, showing them as heterogeneous aerated masses with concentric peripheral contrast enhancement 2 . Conservative methods for treatment of trichobezoar are not always possible (endoscopic removal and use of enzyme solutions) because they offer parallel risks of gastric perforation and intestinal obstruction 4,1 . Therefore, surgical treatment is most effective and thus dominant, leading to direct removal of the foreign body mainly through longitudinal anterior gastrotomy 4 .…”

Tricobezoar gástrico

“…Bezoar pode ser definido como impactação de material estranho no interior do trato digestivo, originada a partir da ingestão de cabelos, pêlos, fibras vegetais e outros alimentos não-absorvíveis 1 .…”

“…Os bezoares podem ser divididos em fitobezoar (acúmulo de fibras ou sementes de vegetais), tricobezoar (cabelo), tricofitobezoar (mistura dos anteriores), lactobezoar (leite coagulado), litobezoar (pedras) e outros bezoares de origens variadas [1][2][3] .…”