pica and Emergencies

Ingestion of multiple magnets may cause serious gastrointestinal morbidity, such as pressure necrosis, perforation, fistula formation, or intestinal obstruction due to forceful attraction across bowel wall. Although the consequences of multiple magnet ingestion are well documented in young children, the current popularity of small, powerful rare-earth magnets marketed as "desk toys" has heightened this safety concern in all pediatric age groups. A recent US Consumer Product Safety Commission product-wide warning additionally reports the adolescent practice of using toy high-powered, ball-bearing magnets to simulate tongue and lip piercings, a behavior that may increase risk of inadvertent ingestion. We describe 2 cases of older children (male; aged 10 and 13 years, respectively) with unintentional ingestion of multiple rare-earth magnets. Health care providers should be alerted to the potential for misuse of these high-powered, ball-bearing magnets among older children and adolescents.

Topics: Adolescent; Child; Emergencies; Endoscopy, Digestive System; Foreign Bodies; Gastrointestinal Hemorrhage; Humans; Magnets; Male; Metals, Rare Earth; Pica; Play and Playthings

Bezoars and foreign bodies are frequently encountered in children with psychiatric disorders. Eating disorder (called pica) occurs predominantly in some high-risk patients such as psychiatric and mentally disabled children. Small-bowel obstruction is an uncommon complication of ingested foreign body because the foreign body is able to cross the whole small intestine and be excreted in the feces.We present the case history of an autistic adolescent who was operated on because of bowel obstruction due to an unusual foreign body.

Topics: Adolescent; Autistic Disorder; Bezoars; Cardia; Cellulitis; Diagnosis, Differential; Duodenum; Emergencies; Enterostomy; Foreign Bodies; Gastroscopy; Humans; Ileal Diseases; Intestinal Obstruction; Laparoscopy; Laparotomy; Male; Pica; Plant Structures; Umbilicus

Pica is a pathologic craving for substances not commonly regarded as foods. In this study the authors report their experience about five cases presented with an acute abdomen following foreign bodies ingestion by patients mentally handicapped. Therapeutic treatment was emergency laparatomy with postoperative morbidity of 40% and mortality of 40%. It is hoped that specific drug therapy with more aggressive surgical treatment will reduce the mortality significantly.

Topics: Abdomen, Acute; Adolescent; Adult; Emergencies; Fatal Outcome; Female; Foreign Bodies; Humans; Male; Middle Aged; Pica; Psychotic Disorders

Acute lead encephalopathy has become a rare syndrome in the United States. Early recognition of the disease, with institution of specific chelation therapy, is critical in order to minimize mortality and morbidity. Lead intoxication, however, may mimic other more common diseases. We report an 8-year-old child with known sickle cell anemia who presented initially with findings suggestive of vaso-occlusive crisis but who deteriorated rapidly and was found to have severe lead poisoning. We present her hospital course and review the management of lead encephalopathy in detail.

Topics: Anemia, Sickle Cell; Brain Diseases; Chelating Agents; Child; Diagnosis, Differential; Emergencies; Erythrocytes; Exchange Transfusion, Whole Blood; Female; Follow-Up Studies; Humans; Lead; Lead Poisoning; Pica; Protoporphyrins; Seizures; Socioeconomic Factors