"La práctica médica no entraña solamente tejer, entretejer y tener activas las manos, sino que debe inspirarse en el alma, estar plena de conocimiento y tener como componente preciado la observación aguda y minuciosa; todo ello, junto con los conocimientos científicos exactos, son los requisitos para que la práctica médica sea eficiente."
Moisés ben Maimón (1135-1204)

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domingo, 13 de enero de 2008

Un caso de tricofagia

¿¿Qué es lo que ves??
'Eso' que ves nos es mas que una maraña de pelos encontrada en el estómago de una fémina de 18 años. Obviamente trastornada por la tricofagia la mujer desde niña mascaba su cabellera y años después comenzó a presentar dolores abdominales, vómitos y mareos, los medicos no encontraban nada anormal en los estudios, ya que ni los Rx ni el ultrasonido detectaban la bola, fue necesario intervenirla, para encontrar la causa de sus males, una bola de cabellos de casi 5 kilos, que como se ve en la foto, tomo la forma del estomago, la foto y la información fue publicada en The New England Journal of Medicine.

Original:
Trichobezoar
A previously healthy 18-year-old woman presented with a 5-month history of pain in the left upper quadrant of the abdomen, abdominal distention, postprandial emesis, and weight loss of 18 kg. Physical examination revealed a firm, tender, epigastric mass but was otherwise unremarkable. Computed tomography showed a large gastric mass extending from the fundus to the antrum (Panel A, arrow), with no indication of obstruction of the gastric outlet. Esophagogastroduodenoscopy revealed a large bezoar occluding nearly the entire stomach, without extension into the duodenum (Panel B). On questioning, the patient stated that she had had a habit of eating her hair for many years — a condition called trichophagia. Owing to the large size of the trichobezoar (37.5 by 17.5 by 17.5 cm), endoscopic removal was not attempted. Laparoscopic removal was attempted; however, conversion to an open procedure was required to completely remove the 4.5-kg trichobezoar (Panel C). The patient was tolerating a general diet by postoperative day 5 and was discharged to her home, with psychiatric and surgical follow-up. One year after the surgery, she has no abdominal pain or vomiting. She has regained approximately 9 kg of body weight and reports that she has stopped eating her hair.

1 comentario:

Franck dijo...

Thanks a lot. your information was Illustrated..