RESUMO
BACKGROUND: Ingestion of foreign bodies represents a common feature in psychiatric patients and prisoners. Bezoar is a conglomeration of partially or undigested foreign material in the gastrointestinal tract. These are classified into several types according to the materials which they are composed of, the least frequent being metals. There are few cases reported in the literature. CLINICAL CASE: We report a case of a patient with a pathological history of mental disorder. The patient complained of abdominal pain 24 h prior, and there were no other symptoms. Physical examination revealed pain in the upper quadrant without peritoneal irritation. Laboratory tests were normal and plain x-ray of the abdomen showed several metallic foreign bodies, some sharp, >5 cm in length and with intestinal prolongation. Surgical intervention was performed several hours later: gastrotomy to remove the gastric bezoar that was composed of several screws, nails, scrap metal, lighters, clothespins, radio antennas and one coin. Four metallic foreign bodies were found in the small bowel after reviewing the abdominal cavity, so enterotomy was also performed to remove them. Postoperative course was uneventful. CONCLUSIONS: Surgical treatment must be considered in cases of multiple, large, sharp objects or complications. An exhaustive study of the case is essential to avoid delay in treatment and potential complications.
