Intussusception as an unusual etiology of intestinal obstruction in adults: case report and review

Intussusception is a rare entity in adults, representing 1 to 5 percent of cases of intestinal obstruction. The clinical manifestations are non-specific, a structural lesion is identified by imaging, in more than 70% of the cases. Most cases require surgical treatment. We report the case of a 65-year-old female patient, with a history of intermittent colicky abdominal pain of two months of evolution, associated with nausea, vomiting, melena, and weight loss. Assessed in the emergency department due to worsening abdominal pain and lack of defecation. Her laboratory data reported anemia and leukocytosis. Abdominopelvic CT scan reported an image compatible with intussusception. We performed an emergency exploratory laparotomy, finding the terminal ileum invaginated into the colonic lumen., caused by a gastrointestinal stromal tumor. Intussusception in adults is uncommon but it should be considered as a diagnostic possibility in patients with intestinal obstruction, intestinal bleeding, and a palpable abdominal mass. Although these are non-specific manifestations, complementing the study with chemical and imaging analyzes significantly increases the diagnostic probability. The set of data obtained should be used to select the most appropriate treatment

Bezoars: diagnosis, management, and potential complications in patients with psychiatric disorders

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.