Tricobezoar gástrico: relato de caso e revisão da literatura

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.

Sugarcane fibre may prevents hairball formation in cats

Hair ingested by licking during cat grooming can eventually coalesce into solid masses in cat gastrointestinal tract. It is believed that dietary fibre might reduce formation of these trichobezoars (hairballs). The effects of two insoluble fibre sources added to kibble diets were evaluated with respect to trichobezoar faecal excretion. Thirty-two cats and four diets were used in a randomised block design: a control diet without additional fibre, 10 % added sugarcane fibre, 20 % added sugarcane fibre or 10 % added cellulose. Animals were fed for 42 d and during three separate periods (days 15-17, 25-27 and 40-42), the cats were housed individually in metabolic cages and their faeces were totally collected. The faeces were evaluated and the trichobezoars were isolated and classified into small (<1 cm), medium (1·1-2 cm) or large (>2·1 cm). Means were evaluated by repeated measures ANOVA and contrasts (P < 0·05). Cats fed sugarcane fibre shown a linear reduction of small and medium trichobezoar excretion (number per cat per day; P = 0·004) as well as a reduction in trichobezoar mass excretion (mg per cat per day; P < 0·01). The control group showed increased faecal excretion of large trichobezoars (P = 0·003), which were not present in the high sugarcane fibre group (P < 0·006). No effect of cellulose was observed for any evaluated trait. Therefore, long fibres (sugarcane fibre) may cause greater peristaltic stimulation, increasing the propulsion of hair through the gut, but further research is needed to validate this mechanism. In conclusion, sugarcane fibre reduced faecal hairball elimination in cats, which may have clinical applications for the prevention of health problems related to trichobezoars.