pica and Colonic-Diseases

The authors describe a patient with chronic renal failure who developed intestinal obstruction from talcum powder pica. A literature review found 43 previously reported cases of surgical complications caused by various forms of pica. Most occurred in women, blacks, aborigines, children, or the mentally retarded--all groups in whom pica occurs more frequently than the general population. Intestinal obstruction was the most common clinical presentation and the ileum most often the site of obstruction reported at surgery. Perforation with peritonitis was the next most common presentation but three cases of colon perforation were diagnosed only at surgery or postmortem. Mixed pica (paper, plastic bags, cloth, string) seemed more likely to require surgery and to cause perforation. An accurate preoperative diagnosis was made most often when a history of pica was sought, and opacity on abdominal X rays correctly interpreted. These clues to pica as the underlying cause of abdominal complaints should not be neglected in patients who are members of the groups known to be at higher risk of this compulsive eating disorders.

Topics: Abdominal Pain; Adult; Colonic Diseases; Female; Humans; Intestinal Obstruction; Kidney Failure, Chronic; Kidney Transplantation; Pica

A bezoar is an accumulation of indigestible exogenous matter in the stomach and intestine. A myriad of ingested substances have been found impacted in the digestive tract. Bezoars are uncommon causes of intestinal obtruction during childhood. Lithobezoar, an accumulation of ingested stones within the alimentary tract, is an extremely rare clinical entity. We report one such case in a 9-year-old boy with a history of pica and long-term constipation resulting in intestinal obstruction secondary to a colonic lithobezoar. Only two such cases have been reported previously.

Topics: Bezoars; Child; Colonic Diseases; Enema; Fecal Impaction; Humans; Intestinal Obstruction; Male; Pica

Topics: Abdomen, Acute; Abscess; Colonic Diseases; Female; Humans; Intestinal Perforation; Middle Aged; Peritonitis; Pica; Sigmoid Diseases; Soil

Topics: Colonic Diseases; Foreign Bodies; Gastric Fistula; Humans; Intestinal Fistula; Male; Pica; Psychophysiologic Disorders; Stomach

Topics: Adult; Aluminum Silicates; Clay; Colonic Diseases; Female; Humans; Intestinal Obstruction; Intestinal Perforation; Pica; Pregnancy; Pregnancy Complications

Eleven Aboriginal patients from the Northern Territory, in whom radiological examination of the abdomen demonstrated opaque masses of clay in the colon are described. This was due to the eating of white clay which is found only in streams, springs and billabongs of the coastal areas of the Territory. The habit does not appear to be a perversion of appetite, nor is it related to anaemia or pregnancy. The clay is eaten mainly for medicinal purposes or to allay hunger. The results are not always beneficial, since clay caused complications (including obstruction and perforation of the colon) in five of our 11 patients.

Topics: Adolescent; Adult; Australia; Child, Preschool; Colonic Diseases; Female; Humans; Intestinal Obstruction; Intestinal Perforation; Male; Medicine, Traditional; Middle Aged; Native Hawaiian or Other Pacific Islander; Pica; Radiography

A case of stercoraceous perforation of the bowel in a 31-year-old woman, an habitual paper eater, is reported. Treatment was by evacuation of the faecal mass through the enlarged perforation and direct closure of the perforation without proximal colostomy.

Topics: Adult; Cathartics; Colonic Diseases; Feces; Female; Humans; Intestinal Perforation; Pica