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Daniel José Szor - Faculdade Israelita de Ciências da Saúde Albert
Einstein
Danielle Tamashiro Duarte - Faculdade Israelita de Ciências da Saúde
Albert Einstein
Fernanda Barma Leitzke - Faculdade Israelita de Ciências da Saúde Albert
Einstein
Francisco Tustumi - Hospital Israelita Albert Einstein
Marcos Antonio Neves Noronha - Hospital Israelita Albert Einstein
Márcio Fuginami Goto - Hospital M´Boi Mirim
Corresponding author:
daniel.szor@einstein.br
Written informed consent was obtained from the patient to publish this
report in accordance with the journal’s patient consent policy.
We have no conflict of interest to declare.
A bezoar is a group of undigestable or partially digested material
that accumulates in the gastrointestinal tract¹. The intentional or
accidental ingestion of different materials might cause a bezoar. The
majority of the bezoars are located in the stomach but occasionally in
the small intestine.
An unusual practice to lose weight is the ingestion of some material to
replace food such as cotton balls, leading to loss of appetite and
possible loss of weight².
A 29-year-old patient was admitted to the emergency room reporting
abdominal distention for the last 24 hours. Also, she reported the
intentional ingestion of several cotton balls 14 days later as part of a
diet to lose weight. The patient reported a gastric bypass due to
obesity seven years ago.
Abdominal computed-tomography revealed small intestinal distention with
an intraluminal mass in the distal ileum (Figure 1).
An exploratory laparotomy was performed and several cotton balls were
retrieved after enterotomy (Figure 2). The patient was discharged
uneventfully three days later.
This case brings attention to the risk of some practices for losing
weight. Alson, the presence of a gastrojejunal anastomosis facilitates
the passage of more extensive solid content compared to
pylorus-preserving surgeries, leading to small bowel obstruction.
References
Iwamuro M, Okada H, Matsueda K, et al. Review of the diagnosis and
management of gastrointestinal bezoars. World J Gastrointest Endosc.
2015;7(4):336-345. doi:10.4253/wjge.v7.i4.336
Chintamani, Durkhure R, Singh JP, Singhal V. Cotton Bezoar–a rare
cause of intestinal obstruction: case report. BMC Surg. 2003;3:5.
Published 2003 Sep 4. doi:10.1186/1471-2482-3-5