Caso clínico 1: tricobezoar gástrico gigante. Caso clínico 2: tumor del estroma gastrointestinal (GIST) yeyunal

Abstract

Clinical case giant gastric trichobezoar Introduction: bezoar is an uncommon pathology, which can occur associated with various diseases generally is more common in pediatric patients or with psychological and psychiatric disorders, usually occurs by ingestion of foreign bodies, both organic or inorganic matter that accumulates in the stomach and does not undergo degradation by gastric juice, preventing future ingestions are also not digested, leading to accumulation of material and ultimately different digestive disorders. Clinical case: female patient of 16 years of age, during the anamnesis refers as personal history, trichophagia and no family history of importance, also indicating that previously went to private consultation, for presenting abdominal pain and dyspepsia, before which the specialist requested an upper digestive endoscopy, the specialist requested an upper endoscopy, which revealed a giant trichobezoar of hard consistency, smooth surface, non-movable, occupying 60% of the gastric lumen, corresponding to the gastric fundus, body and antrum, with extension into the duodenum, which was confirmed with an abdominal tomography. Due to the failures of endoscopic extraction, surgery was performed. The patient had a favorable postoperative evolution, with outpatient follow-up and outpatient medical treatment. Conclusions: it can be concluded that trichobezoar is a rare pathology, generally due to its nature it is diagnosed in advanced stages being its treatment surgical, but its integral management is multidisciplinary. Clinical case gastrointestinal stromal tumor (GIST) jejunal Introduction: gastrointestinal stromal tumors (GIST) infrequent tumors at the level of the jejunum, it is considered that depending on their size and histological type they may have malignant potential. In early stages they are asymptomatic or produce non-specific symptoms such as abdominal pain, gastrointestinal bleeding of obscure origin, and early satiety among others. In some cases they are diagnosed incidentally in imaging studies, endoscopies or during surgeries in the abdominal cavity. Tumors do not usually recur but immunohistochemistry is necessary to decide if adjuvant treatment is needed. Case report: 38-year-old male patient, with no relevant history, attended the emergency room of a public hospital with symptoms of eight days of evolution characterized by melaenic stools three times a day, associated with asthenia and general malaise. Upper gastrointestinal endoscopy was performed with findings of gastric ulcers without recent bleeding, without taking a biopsy due to syncope during the procedure. Hemoglobin decreased to 5.2g/dl, so surgery was performed and a stromal tumor was found 40 centimeters from the angle of treitz, resection and anastomosis were performed. The patient presented a favorable evolution and was discharged ten days later with ambulatory treatment and outpatient control. Conclusions: jejunal gist are rare tumors of difficult diagnosis due to their location and obscure symptomatology, although with the advance of technology there is a promising future in terms of early diagnosis and treatment. keywords: