Portal de Periódicos da CAPES

Dry Fruit Bezoar Causing Acute Small Intestinal Obstruction

2007; SAGE Publishing; Volume: 15; Issue: 1 Linguagem: Inglês

10.1177/1066896906295686

1940-2465

Carlos Ortiz‐Hidalgo, Teresa Cuesta-Mejías, Jorge Cervantes-Castro,

Therapeutic Uses of Natural Elements

story is told that a castle in Cordova, Spain, was given in exchange for a bezoar. In A Voyage to Abyssinia, written by Father Jeronimo Lobo in the 17th century, based on his travels to Boa, he says: “I had recourse to bezoar, a sovereign remedy against these poisons, which I always carried about me.” Belief in bezoars’ near-magical properties was then common. The magical medical properties of bezoars were tested in 1575 by the French surgeon Ambroise Pare. A cook at Pare’s court was caught stealing fine silver cutlery, and Pare offered the thief a choice between public strangulation and swallowing lethal poison along with a bezoar stone. The cook agreed to be poisoned and then treated with a bezoar stone, but to no great avail as he died in agony days later. It difficult to imagine the high esteem of bezoars in those days if one thinks of the foul-smelling masses On December 26, 2005, a 56-year-old woman presented to the ABC Medical Center in Mexico City complaining of abdominal pain. She had no teeth and had practically swallowed dry fruit whole during Christmas dinner. On presentation, she had abdominal distention and pain. An abdominal radiograph revealed a bowel mass in the right iliac fossa. An exploratory laparotomy revealed numerous undigested fragments of dry fruit causing luminal obstruction of the terminal ileum (Figure 1). Acute intraluminal occlusion of the small bowel is uncommon. Among the causes, bezoars are the most common, usually occurring in patients with a history of previous gastric surgery, poor mastication, overindulgence of food with a high fiber content, or psychiatric ailments. A bezoar is a large mass of undigested foreign material usually made of hair (trichobezoar), vegetable material (phytobezoar), or persimmon pulp (diospyrobezoar) that collects in the gastrointestinal tract. Bezoars composed of concentrated milk products (lactobezoar) and of mixed medication and food bolus have also been described. Bezoars were believed to have the power of universal cure against any poison. The word bezoar means “antidote” and comes from the Persian pâdzahr or the Arabic bedsehr. In fact, some types of trichobezoar are apparently able to participate in the binding of arsenic compounds from solutions. Bezoars could be swallowed or rubbed on the infected part and became prized possessions. The