Intestinal Obstruction Caused By Phytobezoar Composed Of Jaboticaba Seeds: Case Report And Literature Review

Bezoar is a cluster of swallowed and undigested material in the gastrointestinal tract which can cause intestinal obstruction. It has multiple subtypes and the phytobezoar (composed of vegetable fiber) is the most common. We report a patient admitted with intestinal obstruction caused by impaction of multiples seeds of jaboticaba in the rectum. The treatment included multiple enemas, laxatives and digital maneuvers and it was effective after four days. Only one similar report was found in the literature.323308311Coelho, J.C.U., Gonçalves, C.G., Madureira, F.D., Bezoar (2004) Aparelho Digestivo: Clínica E Cirurgia, pp. 595-599. , Coelho JCU, 3a ed. São Paulo: AtheneuBandeira, F.A.A., de Tavares, S.V.C., Arruda, P.C.L., Leão, C.S., Campos, J.M., Ferraz, E.M., Obstrução gastrointestinal por fitobezoar na cirurgia bariátrica (2006) Rev Col Bras Cir, 33 (1), pp. 35-38Dasgupta, H.K., Chandra, S.S., Gupta, M., Sanwal, B.L., Bhargawa, S.C., Vaid, R.L., Trichobezoar: Clinical diagnosis (a case report) (1979) J Postgrad Med, 25 (3), pp. 181-182Madura, M.J., Naughton, B.J., Craig, R.M., Duodenal bezoar: A case report and review of the literature (1982) Gastrointest Endosc, 28 (1), pp. 26-28Escamilla, C., Robles-Campos, R., Parrilla-Paricio, P., Lujan-Mompean, J., Liron-Ruiz, R., Torralba-Martinez, J.A., Intestinal obstruction and bezoars (1994) J Am Coll Surg, 179 (3), pp. 285-288Grimaldi, A., Engels, J., Brassier, D., Maisani, E., Phytobezoard secondaire à une gastropathie diabétique (1982) Nouv Presse Med, 11 (4), p. 282Kuiper, D.H., Gastric bezoar in a patient with myotonic dystrophy. A review of the gastrointestinal complications of myotonic dystrophy (1971) Dig Dis, 16 (6), pp. 529-534van Thiel, D.H., Debelle, R.C., Painter, T.D., McMillan, W.B., Haradin, A.R., Phytobezoa occuring as a complication of gastric carcinoma (1975) Gastroenterology, 68 (5 Pt 1), pp. 1292-1296Tolia, V., Dubois, R.S., Lactobezoar in prematurity. A case with prolonged resolution (1981) Clin Pediatric, 20 (10), pp. 651-653Andrus, C.H., Ponsky, J.L., Bezoars: Classification, pathophysiology, and treatment (1988) Am J Gastroenterol, 83 (5), pp. 476-478Erzurumlu, K., Malazgirt, Z., Bektas, A., Dervisoglu, A., Polat, C., Senyurek, G., Gastrointestinal bezoars: A retrospective analysis of 34 cases (2005) World J Gastroenterol, 11 (12), pp. 1813-1817Hayes, P.G., Rotstein, O.D., Gastrointestinal phytobezoars: Presentation and management (1986) Can J Surg, 29 (6), pp. 419-420Eitan, A., Bickel, A., Katz, I.M., Fecal impaction in adults: Report of 30 cases of seed bezoars in the rectum (2006) Dis Colon Rectum, 49 (11), pp. 1768-1771Martins, C.M.G., Nascimento, N.B., Caroços de jabuticaba desencadeando quadro de suboclusão intestinal (2006) Rev Fac Cienc Med De Sorocaba, 8 (2), p. 31Spadella, C.T., Saad-Hossne, R., Saad, L.H.C., Tricobezoar gástrico: Relato de caso e revisão da literatura (1998) Acta Cir Bras, 13 (2), pp. 110-11

Association between apolipoprotein E genotype, serum lipids, and colorectal cancer in Brazilian individuals

We evaluated genetic variants of apolipoprotein E (APOE HhaI) and their association with serum lipids in colorectal cancer (CRC), together with eating habits and personal history. Eight-seven adults with CRC and 73 controls were studied. APOE*2 (rs7412) and APOE*4 (rs429358) were identified by polymerase chain reaction-restriction fragment length polymorphism. APOE gene polymorphisms were similar in both groups, but the &#949;4/&#949;4 genotype (6%) was present only in controls. The patients had reduced levels (mean ± SD) of total cholesterol and low-density lipoprotein cholesterol fraction (180.4 ± 49.5 and 116.1 ± 43.1 mg/dL, respectively) compared to controls (204.2 ± 55.6, P = 0.135 and 134.7 ± 50.8 mg/dL; P = 0.330, respectively) indicating that they were not statistically significant after the Bonferroni correction. The APOE*4 allele was associated with lower levels of total cholesterol, low- and high-density lipoprotein cholesterol fraction and increased levels of very low-density lipoprotein cholesterol fraction and triglycerides only among patients (P = 0.014). There was a positive correlation between the altered lipid profile and increased body mass indexes in both groups (P < 0.010). Moreover, a higher rate of hypertension and overweight was observed in controls (P < 0.002). In conclusion, the presence of the &#949;4/&#949;4 genotype only in controls may be due to a protective effect against CRC. Lower lipid profile values among patients, even those on lipid-rich diets associated with the APOE*4 allele, suggest alterations in the lipid synthesis and metabolism pathways in CRC