ABSTRACT
Word "bezoar" comes from Persian "pâdzahr," which means "antidote," since, in ancient times, it was believed that bezoar could cure and nullify effects of all poisons. In medical context, bezoar is the term used for conglomerates of undigested material that accumulate in de gastrointestinal tract. Case of 60-year-old female patient with repeated episodes of intestinal obstruction associated with digestive tract bleeding. She presented to emergency department with severe abdominal pain and intolerance to oral route. Computed tomography identified hypodense image suggestive of a oreign body in the small bowel lumen. During laparotomy, stone-like mass of approximately 3×5 cm was found at level of jejuno-ileal junction, 80 cm from Treitz ligament, with presence of an intestinal flange that conditions rotation of the intestinal loop on its axis. Intestinal obstruction due to bezoar is uncommon in adult patients, and symptoms are usually non-specific. It requires a high index of suspicion and effective screening for trichotillomania. In such cases, imaging studies such as tomography help to establish the diagnosis.
ABSTRACT
Several modalities of renal replacement therapy (RRT) are available for the treatment of end-stage renal disease (ESRD). Patients are likely to face complex medical decisions regarding the type of medical therapy they wish to pursue. A prospective, observational, descriptive and cross-sectional survey case series study was carried out in patients with grade 3-5 chronic kidney disease at the General Hospital ‘Dr. Miguel Silva’ without starting renal replacement therapy. We used descriptive statistics to evaluate the frequency of the categorical variables and measures of central tendency and dispersion for the quantitative variables. The total number of patients included was 20, with a mean age of 54.40±15.93 years and an age range between 24 and 78 years; 55% of the patients evaluated obtained a ‘good’ level of knowledge regarding the types of RRT (HD, PD and renal transplantation). All patients received pre-dialysis information before starting the survey. PD was the preferred RRT modality (45%), followed by kidney transplantation (35%) and finally HD (20%). The patient's level of knowledge regarding his chronic kidney disease allows him to make an informed decision about the choice of the ideal treatment. The most preferred renal replacement therapy for previously educated chronic kidney disease patients is peritoneal dialysis. The distance from the hemodialysis center to your home and work activity are important factors in choosing the type of RRT.