{"id":3963,"date":"2021-01-08T09:00:32","date_gmt":"2021-01-08T09:00:32","guid":{"rendered":"https:\/\/endoscopiaterapeutica.net\/pt\/uncategorized\/caso-clinico-corpo-estanho-em-colon\/"},"modified":"2021-09-16T19:04:36","modified_gmt":"2021-09-16T19:04:36","slug":"caso-clinico-corpo-estanho-em-colon","status":"publish","type":"post","link":"https:\/\/endoscopiaterapeutica.net\/pt\/casosclinicos\/caso-clinico-corpo-estanho-em-colon\/","title":{"rendered":"Caso Cl\u00ednico \u2013 Corpo Estranho em C\u00f3lon"},"content":{"rendered":"

Relato do caso:<\/b><\/h2>\n

Paciente do sexo feminino, 75 anos, deu entrada no PS por dor abdominal em flanco esquerdo h\u00e1 cerca de 20 dias, hiporexia, perda ponderal de 5 kg, astenia e febre. Antecedentes: DRGE. Em uso de omeprazol e domperidona. Ao exame f\u00edsico: bom estado geral, afebril, eupneica. PA: 130 x 70, FC: 110 bpm. Abdome: globoso, fl\u00e1cido, doloroso \u00e0 palpa\u00e7\u00e3o profunda em flanco e fossa il\u00edaca esquerda. DB negativo. RHA +.<\/span><\/p>\n

RX de abdome:<\/em><\/strong> Aus\u00eancia de sinais de pneumoperit\u00f4nio, mas com distens\u00e3o de al\u00e7as col\u00f4nicas.<\/span><\/p>\n

\"RX<\/a><\/p>\n

 <\/p>\n

TC de abdome:<\/strong><\/em> Material hiperatenuante alongado na topografia de sigmoide associada \u00e0 densifica\u00e7\u00e3o da gordura sugerindo processo inflamat\u00f3rio (microperfura\u00e7\u00e3o). N\u00e3o identificado pneumoperit\u00f4nio.<\/span><\/p>\n

\"TC<\/a><\/p>\n

 <\/p>\n

Optado por realizar <\/span>colonoscopia<\/span><\/a> que evidenciou um corpo estranho (osso de galinha) em sigmoide transfixando a parede col\u00f4nica em suas duas extremidades com presen\u00e7a de processo inflamat\u00f3rio local (hiperemia e secre\u00e7\u00e3o purulenta), al\u00e9m de in\u00fameros \u00f3stios diverticulares. Optado por mobilizar o osso com pin\u00e7a de corpo estranho (tipo “jacar\u00e9”) para o interior da luz col\u00f4nica e, consequentemente, deslocamento da outra extremidade. Realizada a retirada sem intercorr\u00eancias. Optado por coloca\u00e7\u00e3o de hemoclipes em cada leito. Paciente teve alta ap\u00f3s 48h, com melhora da dor abdominal, sem febre e boa aceita\u00e7\u00e3o de dieta VO.<\/span><\/p>\n

\"colonoscopia<\/a> \"colonoscopia<\/a> \"colonoscopia<\/a><\/p>\n

\"colonoscopia<\/a><\/p>\n

https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2018\/03\/Ale-CE4.mp4<\/a><\/video><\/div>\n
<\/h6>\n

Discuss\u00e3o:<\/h2>\n

A ingest\u00e3o acidental de corpo estranho \u00e9 um problema frequente em atendimentos de emerg\u00eancia. Felizmente, em apenas 1% dos casos ocorre perfura\u00e7\u00e3o em alguma por\u00e7\u00e3o do trato gastrointestinal. Os corpos estranhos alongados e pontiagudos (palito de dente, espinha de peixe e osso de galinha) s\u00e3o os que est\u00e3o mais associados \u00e0 perfura\u00e7\u00e3o, sendo o intestino delgado o local mais frequente. O diagn\u00f3stico, geralmente, \u00e9 tardio e a ingest\u00e3o do corpo estranho n\u00e3o \u00e9 relatada pelo paciente. Idosos, usua\u0301rios de dentaduras, alcoo\u0301latras e pacientes psiquia\u0301tricos s\u00e3o a popula\u00e7\u00e3o mais predisposta.<\/span><\/p>\n

A radiografia convencional tem sensibilidade diminu\u00edda para a maioria dos corpos estranhos. A tomografia de abdome tem melhor sensibilidade e acur\u00e1cia para corpos estranhos calcificados e n\u00e3o calcificados.<\/span><\/p>\n

A perfura\u00e7\u00e3o \u00e9 consequente \u00e0 impactac\u0327a\u0303o e erosa\u0303o progressiva do corpo estranho contra a parede intestinal. O pneumoperit\u00f4nio n\u00e3o \u00e9 comum por conta de o local da perfura\u00e7\u00e3o ser recoberto por fibrina, omento e outras al\u00e7as intestinais, o que limita a passagem de grande quantidade de ga\u0301s para a cavidade peritoneal.<\/span><\/p>\n

O tratamento endosc\u00f3pico <\/span>vs<\/span><\/i> cir\u00fargico vai depender da presen\u00e7a de complica\u00e7\u00f5es (perfura\u00e7\u00f5es com abscesso intracavit\u00e1rio, f\u00edstulas), mas, frequentemente, tende a ser conservador (endosc\u00f3pico).<\/span><\/p>\n

Como citar esse artigo:<\/h2>\n

Carlos, A. Caso Cl\u00ednico \u2013 Corpo Estranho em C\u00f3lon. Endoscopia Terap\u00eautica; 2021. Dispon\u00edvel em: <\/span><\/i>https:\/\/endoscopiaterapeutica.net\/pt\/casosclinicos\/caso-clinico-corpo-estanho-em-colon\/<\/span><\/i><\/p>\n

Refer\u00eancias bibliogr\u00e1ficas:<\/h2>\n
    \n
  1. Clin J Gastroenterol.2017 Dec;10(6):491-497;<\/span><\/li>\n
  2. Nicolodi GC et al Radiol Bras. 2016 Set\/Out;49(5):295\u2013299;<\/span><\/li>\n
  3. World J Surg Oncol.2011 Feb 18;9:24. doi: 10.1186\/1477-7819-9-24;<\/span><\/li>\n
  4. Wien Klin Wochenschr.2009;121(5-6):220-2;<\/span><\/li>\n
  5. Acta Gastroenterol Latinoam.1997;27(5):329-30.<\/span><\/li>\n<\/ol>\n

    Acesse o <\/span>Endoscopia Terap\u00eautica<\/span><\/a> para tomar contato com mais <\/span>artigos comentados<\/span><\/a>, <\/span>assuntos gerais<\/span><\/a>, <\/span>casos cl\u00ednicos<\/span><\/a>, <\/span>quizzes<\/span><\/a>, <\/span>classifica\u00e7\u00f5es<\/span><\/a> e mais!<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

    Relato do caso: Paciente do sexo feminino, 75 anos, deu entrada no PS por…<\/p>\n","protected":false},"author":142,"featured_media":3959,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[150],"tags":[],"ano":[262],"tipo":[156],"volume":[263],"class_list":["post-3963","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-casosclinicos","ano-262","tipo-colonoscopia","volume-volume-i"],"yoast_head":"\nCaso Cl\u00ednico \u2013 Corpo Estranho em C\u00f3lon • Endoscopia Terapeutica<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/endoscopiaterapeutica.net\/pt\/casosclinicos\/caso-clinico-corpo-estanho-em-colon\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" 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