ABSTRACT
Introducción: Un bezoar es un conglomerado de material extraño en el tracto intestinal. El tricobezoar (acumulación de cabello en la cámara gástrica) y el síndrome de Rapunzel (acumulación en el intestino delgado) suelen aparecer en niños y mujeres adolescentes con antecedente de tricotilomanía y tricofagia. Caso clínico: Mujer de 22 años de edad con dolor abdominal intermitente, plenitud gástrica, náuseas, vómito ocasional y pérdida ponderal de 10 meses de evolución. Antecedentes de tricotilomanía, tricofagia y gastrotomía a los 16 años. Los exámenes de laboratorio revelaron anemia microcítica hipocrómica y el ultrasonido mostró una sombra sónica posterior en la cámara gástrica. Por gastrotomía se extrajo un conglomerado de cabello que ocupaba el estómago y parte del intestino delgado. Conclusiones: La tricotilomanía y tricofagia son más comunes en las mujeres menores de 30 años. La sensación que experimentaba la paciente al deglutir los cabellos provocaba la ingesta. La recopilación de datos puede proporcionar información acerca de los determinantes que influyen en la aparición de la enfermedad.
BACKGROUND: Bezoar is a conglomeration of foreign material in the intestinal tract. Trichobezoar (accumulation of hair in the gastric chamber, secondary to impulsive pulling and intake) and Rapunzel syndrome (accumulation of hair in the small intestine) usually occur in children and adolescents with trichotillomania (TTM) and trichophagia history. CLINICAL CASE: We present the case of a 22-year-old female who arrived for consultation. The patient had a 10-month history of intermittent abdominal pain, gastric fullness, nausea, occasional vomiting and weight loss. In addition, she had a history of TTM, trichophagia and previous gastrotomy at 16 years of age. Laboratory tests revealed hypochromic microcytic anemia. Ultrasonographic study demonstrated intense sonic shadowing posterior to the gastric area. After performing gastrotomy, the specimen was extracted and consisted of hair that occupied the entire length of the gastric chamber and part of the small intestine. CONCLUSIONS: TTM is characterized by recurrent and impulsive pulling of one's hair for pleasure, gratification, or relief of tension. Children and women <30 years of age are the groups who most frequently suffer from this type of disorder. Hair intake sensation was a cause for presentation of the disease. Data recollection in our environment may provide information for the determination of new information regarding the presence of this condition.
Subject(s)
Humans , Female , Young Adult , Bezoars/complications , Trichotillomania/complications , Bezoars/diagnosis , Bezoars/surgery , Recurrence , Syndrome , Trichotillomania/diagnosis , Trichotillomania/surgeryABSTRACT
Introdução: Tricofagia é o ato de mastigar e engolir cabelos. Tricobezoares são aglomerado de cabelo singeridos, afetando mais comumente o estômago e o duodeno, podendo causar obstruções, perfurações, ulcerações e sangramentos. Relato do Caso: A finalidade do presente trabalho é relatar o caso de uma paciente com história de cirurgia por tricobezoar há 16 anos, apresentando, no momento da admissão, quadro de obstrução intestinal de mesma etiologia, sendo necessário tratamento cirúrgico para retirada de um tricobezoar gástrico e outro intestinal, o qual causava obstrução a dez centímetros da válvula íleo-cecal. Discussão: O presente relato destaca-se pelo fato de que a paciente apresentou recorrência do tricobezoar e pela obstrução intestinal baixa concomitante. Conclusão: A recorrência do tricobezoar é rara, porém deve ser aventada como hipótese diagnóstica em pacientes que já apresentaram tal afecção e procuram atendimento médico com obstrução intestinal.
Trichophagy is the act of chewing and swallowing hair. Trichobezoars are glomerate of ingested hair, more commonly affecting the stomach and duodenum. They cause obstructions, perforations, ulcerations and bleedings. The purpose of this study is to report the case of a female patient with intestinal obstruction caused by trichobezoars, admitted at a school hospital who had already been submitted to a laparotomy 16 years ago for the same reason. The obstruction was resolved by removing the trichobezoar from the stomach and the ileum after gastrotomy and enterotomy. This case can be considered important since it reports the trichobezoar recurrence as well as the presence of intestinal obstruction . Trichobezoar recurrence is rare, however, this hypothesis must be considered in patients with previous history of this affection who looks for medical assistance in the presence of intestinal obstruction.