Bezoars are foreign bodies impacted in the digestive tract resulting of their ingestion and accumulation, involving mainly the stomach. The most common types are phytobezoars, contaning vegetables, fiber and seed and the trichobezoar, made of hair. The present case is the description of a 25-year-old female with nonspecific dyspeptic symptoms associated to intestinal habit change. The diagnosis was suggested by Computerized Tomography in association with clinical history - initially omitted by the pacient - of trichophagia for 10 years. Treatment consisted of Anterior Gastrotomy and remotion of the bezoar.

INTRODUÇÃO: A angiotomografia coronária de múltiplos detectores (TCMD) vem ganhando confiança como procedimento diagnóstico não-invasivo da doença arterial coronária (DAC). O objetivo deste estudo foi avaliar o desempenho diagnóstico da TCMD e sua influência na modificação das estratégias de revascularização percutânea. MÉTODO: O estudo incluiu dois grupos de pacientes: um grupo principal (GP), composto por 100 pacientes triados com suspeita clínica de DAC grave pela TCMD e indicação de cineangiocoronariografia (CINE), e um grupo controle (GC), para comparação, composto por 100 pacientes selecionados no mesmo período e com indicação de CINE por critérios clínicos ou por positividade de provas funcionais. Foram avaliados o desempenho da TCMD para o diagnóstico de lesões > 50% em segmentos coronários, artérias coronárias e pacientes e as estratégias de revascularização adotadas. RESULTADOS: A sensibilidade, a especificidade e os valores preditivos positivo e negativo da TCMD foram de 86%, 95%, 71% e 100% para os segmentos coronários, de 91%, 92%, 80% e 100% para as artérias coronárias, e de 100%, 90%, 100% e 100% para os pacientes, respectivamente. No GP, a intervenção coronária percutânea (ICP) foi realizada em 90% dos pacientes, enquanto no GC a ICP foi realizada em apenas 43% (P = 0,01). CONCLUSÃO: A TCMD demonstrou alto desempenho na detecção não-invasiva de DAC e proporcionou a realização de ICP ad hoc em 90% dos pacientes. Essa estratégia, no entanto, deverá aguardar estudos randomizados que confirmem esses resultados.

INTRODUCTION: Coronary computed tomographic angiography (CCTA) has been widely accepted as a non-invasive diagnostic tool for coronary artery disease (CAD). The objective of this study was to evaluate the diagnostic performance of CCTA and its influence on modification of percutaneous revascularization strategies. METHOD: The study included two groups of patients: a main group (MG), including 100 patients screened with a suspect of severe CAD by CCTA and indication for coronary cineangiography (CINE), and a control group (CG) for comparison, including 100 patients selected during the same period, with indication for CINE according to clinical criteria or by positive functional tests. We evaluated the performance of CCTA for the diagnosis of lesions > 50% in coronary segments, arteries and patients and the revascularization strategies adopted. RESULTS: The sensitivity, specificity and positive and negative predictive values of CCTA were 86%, 95%, 71% and 100% for the coronary segments, 91%, 92%, 80% and 100% for the coronary arteries and 100%, 90%, 100% and 100% for patients, respectively. In the MG, percutaneous coronary intervention (PCI) was performed in 90% of the patients, whereas in the CG, percutaneous coronary intervention was performed in 43% of the patients (P = 0.01). CONCLUSION: CCTA had a high diagnostic performance in detecting CAD and allowed ad hoc PCI to be performed in 90% of the patients. This strategy, however, must await randomized studies to confirm these results.