pica and Foreign-Bodies

The pica phenomenon, where non-edible substances are repeatedly consumed, has been linked with developmental and behavioural disorders, particularly autism. The clinical presentation of foreign body ingestion in patients with autism is discussed, and recommendations for caregivers are provided based on the available literature. An 18-year-old man with severe autism and behavioural difficulties presented with a vague history of decreased appetite and melaena of eight months duration. Foreign body ingestion commonly occurs in individuals with autism spectrum disorders and should be suspected in patients who present with vague gastrointestinal symptoms. The adverse medical and surgical consequences of foreign body ingestion emphasize the need for early recognition. Surgical intervention for foreign body ingestion can prevent complications. Magnetic substances can cause considerable gastrointestinal morbidity and require urgent endoscopic or surgical removal. Primary prevention is also vital.

Topics: Abdominal Pain; Adolescent; Autistic Disorder; Caregivers; Foreign Bodies; Humans; Magnetics; Male; Metals; Pica; Stomach; Tomography, X-Ray Computed

To review the general surgical management of mentally handicapped persons with pica.. A study of hospital records and a review of the current literature.. A community hospital.. Thirty-five patients from a large institution for the mentally handicapped were treated for well-documented pica on 56 occasions at the Orillia Soldiers Memorial Hospital between 1976 and 1991.. Endoscopy and laparotomy for the removal of foreign bodies or to close perforations.. Fourteen (25%) cases of pica were managed by observation only, but 42 (75%) cases required surgical intervention. There were 34 laparotomies. The complication rate was 30% and the death rate 11%.. Pica is a serious health risk for mentally handicapped patients. Diagnosis and postoperative care can be difficult. Pica should be suspected in mentally handicapped patients with gastrointestinal symptoms.

Topics: Abdomen, Acute; Adolescent; Adult; Digestive System Surgical Procedures; Disabled Persons; Female; Foreign Bodies; Gastric Outlet Obstruction; Humans; Intellectual Disability; Intestinal Obstruction; Intestinal Perforation; Intestine, Small; Laparotomy; Male; Middle Aged; Ontario; Peritonitis; Pica; Retrospective Studies; Survival Rate

Topics: Abdomen; Bezoars; Digestive System Abnormalities; Foreign Bodies; Humans; Pica

Up to 25% of institutionalized patients with cognitive deficiencies display pica-like behavior, with an estimated annual incidence of small bowel obstruction of 2%. We present a case based on the forensic autopsy of a 41-year-old woman who died as a result of a missed diagnosis of small bowel obstruction after ingesting a foreign body. The case underlines the importance of precaution when treating patients with cognitive deficiency and/or language deficits and gastrointestinal symptoms. In such cases, it is important to employ a liberal threshold for radiological investigations and, if possible, obtain a medical history from a person close to the patient.

Topics: Adult; Autopsy; Female; Foreign Bodies; Humans; Intestinal Obstruction; Pica

Tracheobronchial foreign body aspiration (FBA), a common pediatric presentation to emergency departments, is still a public healthcare problem affecting children all over the world. There are several types of foreign bodies reported from different parts of the world, including both organic or nonorganic substances. Pica, another interesting clinical entity, is characterized by persistent eating of nonnutritive substances, which is inappropriate for the maturation stage of the individual. A 3-year-old pediatric patient was admitted to our emergency department with a 3-day history of coughing and new onset respiratory distress. A chest X-ray was performed and it showed a suspicious radiopaque foreign body in the localization of left bronchi. Urgent rigid bronchoscopy was performed. The foreign body in the left main bronchi was, surprisingly, a 0.5-1 cm diameter, irregularly shaped stone particle. The laboratory evaluations and patient history revealed the diagnosis of severe iron deficiency anemia and accompanying pica. Stone aspiration, as an FBA, is a rare but potentially life-threatening complication of pica. Iron deficiency anemia accompanied by pica should be diagnosed and treated in the early stage of the disease because of their complications. According to our knowledge and literature search, this is the first case of stone aspiration as a complication of severe iron deficiency anemia and pica.

Topics: Bronchi; Bronchoscopy; Child; Child, Preschool; Foreign Bodies; Humans; Infant; Pica; Respiratory Distress Syndrome; Retrospective Studies

In this report, a pediatric case of bowel obstruction with sepsis complicated by methamphetamine toxicity is described. The decedent, an eleven-year-old female with a clinical history of pica, was found unresponsive in her home and pronounced dead following unsuccessful resuscitative efforts. Radiologic imaging showed multiple radio-opaque foreign objects in the stomach and bowel. Autopsy revealed a green leafy substance, coins and other metallic items, folded paper, and plastic in her stomach and bowels. Postmortem iliac blood and urine tested positive for amphetamine and methamphetamine. While the decedent's medical history and autopsy findings provided evidence consistent with bowel obstruction with sepsis due to the ingestion of foreign materials, the high methamphetamine concentration was suggestive of concurrent methamphetamine toxicity. Unique complications associated with this case include the phenomenon that methamphetamine toxicity and bowel obstruction can present similarly in children and the reported opinion that accidental drug ingestion is uncommon in children over the age of five. This case emphasizes that the age range for suspected accidental drug ingestion should be expanded for those with pica, as these patients, despite being older, may not be able to differentiate between what they should and should not ingest. Furthermore, when treating a pediatric patient with pica that appears to present with bowel obstruction, unintentional drug ingestion should also be considered, particularly if there is a suspicion that the child lives in a household where drugs are abused, given the prospect that drug toxicity can present similarly.

Topics: Amphetamine; Central Nervous System Stimulants; Child; Colon, Sigmoid; Drug Overdose; Female; Foreign Bodies; Humans; Intestinal Obstruction; Methamphetamine; Pica; Sepsis; Stomach

A young adult black female, known to be a prostitute and suspected of smuggling narcotics, was found dead in her apartment in a state of early decomposition. Oval-shaped gray-white masses of exogenous origin protruded from the anus. The autopsy showed dilatation of the folds of the large intestine, which were almost completely filled with these oval-shaped gray-white masses of foreign material. The uterus was enlarged with multiple large leiomyomas. Toxicological tests of blood and the foreign material revealed no toxicologically relevant substances. Kaolin was detected in a sample of the foreign material from the large intestine. The immediate cause of death was intestinal obstruction due to the formation of a kaolin bezoar with simultaneous compression of the large intestine by the enlarged myomatous uterus. Subsequent revelation of a habit the deceased had brought from her native country led to the conclusion that this exotic custom was responsible for her death.

Topics: Bezoars; Fatal Outcome; Female; Foreign Bodies; Humans; Intestinal Obstruction; Kaolin; Leiomyomatosis; Nigeria; Pica; Sex Workers; Uterine Neoplasms; Young Adult

We describe an 8-year-old white boy with a history of fetal alcohol syndrome and pica, who was found dead on the floor by his mother. The child died from massive intestinal dilatation causing asphyxia. We discuss the potential pathogenetic mechanisms of intestinal dilation in patients with fetal alcohol syndrome.

Topics: Asphyxia; Child; Fetal Alcohol Spectrum Disorders; Foreign Bodies; Humans; Intestinal Obstruction; Male; Pica

We present the case of a 42-year-old man, with a medical history of schizophrenic psychosis, who was found dead on the floor of his bedroom. At the autopsy, a bottle lid with a notched edge was found in the lower pharynx, partially obstructing the larynx and thus keeping the epiglottis in an open position. Airway obstruction was caused by edema and inflammation of the surrounding tissue. After removal of the foreign body, the tissue of the larynx was left with an impression of the bottle lid. The adjacent mucosa was swollen, hyperemic, partly necrotic, and covered with fibrin deposits. Also, foreign bodies were found in the stomach. The histological analysis of the hypopharynx showed severe nonspecific inflammation and necrosis of epithelium. The cause of death was a complication of subacute laryngeal obstruction caused by a foreign body.

Topics: Adult; Airway Obstruction; Asphyxia; Fatal Outcome; Foreign Bodies; Gastrointestinal Contents; Humans; Male; Pica; Schizophrenic Psychology

Topics: Abdominal Pain; Bezoars; Dilatation, Pathologic; Foreign Bodies; Humans; Intestinal Obstruction; Male; Middle Aged; Pica; Schizophrenia

Topics: Abdominal Pain; Cognitive Dysfunction; Constipation; Foreign Bodies; Heart Arrest; Humans; Male; Middle Aged; Pica; Rectal Diseases

Topics: Adult; Fatal Outcome; Foreign Bodies; Forensic Pathology; Gastrointestinal Tract; Hemorrhage; Humans; Male; Pica

Determining the cause of death and differentiating self-inflicted injuries from non-self-inflicted injuries is a primary goal in legal medicine. Especially with unidentified decedents, autopsy findings alone are often not sufficient; there is no knowledge of pre-existing conditions and only circumstantial evidence is available from the scene of death. In our case, radiological, histological, and toxicological examinations provided an explanatory model for extraordinary autopsy findings consistent with pica, a rare eating disorder. In cases of pica, variable and potentially lethal complications emerge, depending on the type and amount of material ingested. Our case is of an apparently uncontrolled intake of wooden objects (xylophagia). The resulting mechanical damage to the gastrointestinal tract and subsequent soft tissue damage supports that this behavioral disorder is not only of medical concern, but also identifies it as a mental disease with medico-legal relevance.

Topics: Autopsy; Biopsy; Cause of Death; Fatal Outcome; Foreign Bodies; Homicide; Humans; Male; Pica; Predictive Value of Tests; Risk Factors; Suicide; Tomography, X-Ray Computed; Wood; Wounds and Injuries

Topics: Abdomen; Anemia, Iron-Deficiency; Celiac Disease; Child, Preschool; Female; Foreign Bodies; Humans; Lactulose; Pica; Radiography

Topics: Adult; Esophagoscopy; Female; Foreign Bodies; Humans; Mediastinum; Neck; Pica; Radiography

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

The majority of ingested foreign bodies pass of their own accord without causing any adverse impact on the patient, while others present a greater management dilemma. We present a case of a 36-year-old man admitted to the hospital with a 10-day history of colicky abdominal pain following voluntary ingestion of multiple pairs of vinyl gloves. The plain-film abdominal X-ray confirmed small bowel obstruction and gastric bezoar. After failed conservative management he opted for endoscopic retrieval. Following exposure to stomach acid the gloves had lost their structural integrity becoming hard, sharp and brittle. As a result endoscopic removal was abandoned due to the risk of traumatic injury to the oesophagus. A midline laparotomy was performed and the gloves were retrieved via enterotomy. While many foreign bodies are suitable for endoscopic extraction this case demonstrates that the retrieval of vinyl gloves is unlikely to be successful due to significant chemical change.

Topics: Adult; Bezoars; Conversion to Open Surgery; Foreign Bodies; Gastroscopy; Humans; Ileal Diseases; Intestinal Obstruction; Intestinal Perforation; Male; Pica; Treatment Outcome

Topics: Anesthesia, Inhalation; Child, Preschool; Corneal Perforation; Female; Foreign Bodies; Humans; Laryngeal Masks; Palate, Hard; Pica; Tongue

This case concerns a 10-year-old boy with a history of behavioral abnormality that arrived at our surgical emergency room with acute abdominal discomfort. The boy had acute colitis-like clinical symptoms resulting from ingested and retained foreign bodies in the colon. These foreign bodies (gravel and stones) had accumulated in the entire colon over a period of 1 year. Attempts to dislodge the foreign bodies from the rectum by mechanical means failed; therefore the possibility of surgical intervention was considered in view of the worsening colitis. However, the problem was finally resolved by repeated basketting by colonoscopy, antibiotics and later laxatives. The case is noteworthy because of the extent of the condition, difficulty of the decision-making, and the relative success of watchful conservative measures.

Topics: Child; Colitis; Foreign Bodies; Humans; Intestinal Obstruction; Male; Pica

Topics: Foreign Bodies; Humans; Mental Disorders; Pica; Risk Factors; Self-Injurious Behavior

There are many ways how children with mental illness have actually tried to hurt themselves. Suicidal thinking or attempts always indicate that professional help is needed (2). Every object which can be potential dangerous should be removed but this is very difficult to do. Some of children with these symptoms had Pica diseases. Pica is a medical disorder characterized by an appetite for substances largely non-nutritive (e.g. metal, coal, soil, feces, paper, soap, gum, etc.) or an abnormal appetite for some things that may be considered foods.. The patient swallow sponge from a pillow over a long period of time and she came into our hospital with abdominal pain. She was 16 years old and had abdominal distension, vomiting, abdominal cramping and failure to pass gas or stool. Immediately we suspected mechanical blockade of the intestine. Diagnosis was clinically confirmed by X-rays of the abdomen and with ultrasound.. The operative treatment was indicated and we found the proximal bowel distended and the distal segment collapsed. The part of bowel necrosis was removed and anastomosis was done.. When patients are determined to attempt suicide or have Pica disorder it is very difficult to prevent.

Topics: Adolescent; Female; Foreign Bodies; Humans; Intestinal Obstruction; Pica; Suicide, Attempted

The case of a 64-year-old patient with pica and severe mental retardation who was admitted to our hospital for treatment of recurrent cholecystitis is reported. Abdominal ultrasound showed sludge in the gallbladder, but no stones. Abdominal CT revealed a foreign body in the duodenum resembling a suction cup of the type commonly used in kitchens and bathrooms. The object could not be removed because it was deeply embedded in the hypertrophic intestinal mucosa. A nasogastric tube was inserted for feeding, since the object impeded the passage of solid foods. The patient's fever and abdominal pain subsequently resolved, and laboratory data improved. The indwelling feeding tube prevented recurrence of cholecystitis. Since pica is common not only in patients with mental retardation but also in dementia patients, the present case may also relate to the treatment of acute abdominal conditions in dementia patients.

Topics: Abdominal Pain; Cholecystitis; Duodenum; Female; Fever; Foreign Bodies; Humans; Imaging, Three-Dimensional; Intellectual Disability; Intubation, Gastrointestinal; Middle Aged; Pica; Recurrence; Tomography, X-Ray Computed; Treatment Outcome

Topics: Child, Preschool; Colon, Descending; Colon, Sigmoid; Diagnosis, Differential; Foreign Bodies; Humans; Male; Pica; Radiography; Treatment Outcome

Topics: Foreign Bodies; Humans; Male; Pica; Stomach; Young Adult

Acquired copper deficiency anemia is rare in humans. This report describes a 38-year-old schizophrenic man with metal pica, especially coins, who presented with symptomatic anemia. Two hundred seventy-five coins were surgically removed from the gastrointestinal tract of this patient during the course of his hospitalization. Some of the post-1981 pennies, which consist primarily of zinc, showed severe corrosion because of their prolonged contact with acidic gastric juice. The patient presented with clinical manifestations consistent with the local corrosive as well as the systemic effects of zinc intoxication. His treatment and outcome are presented. The effects of zinc intoxication on hematologic and other organ systems and on copper absorption are discussed.

Topics: Anemia; Copper; Foreign Bodies; Gastrointestinal Tract; Humans; Male; Middle Aged; Numismatics; Pica; Schizophrenia; Zinc

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

The article shows the description of the seldom met case of simultaneous appearing of numerous foreign bodies situated both in air passages and in the alimentary canal at patient of mentally handicapped with the tendency to swallowing of small objects. After observing by guardians of the patients fact of swallowing metallic foreign bodies by him the specified research were made (X-ray pictures, computer tomography) and the presence in the bronchial tree of both lungs and in the upper and lower section of the alimentary canal were confirmed. Swallowed and aspirated objects did not cause no complaints at the patient. Revealed foreign bodies were removed from air passages by using of the bronchofiberoscopy method and the surgical treatment. Foreign bodies of the alimentary canal were voided by patient through natural tract.

Topics: Bronchi; Digestive System; Foreign Bodies; Humans; Lung; Male; Mental Disorders; Middle Aged; Pica

Topics: Cheek; Chelation Therapy; Child, Preschool; Dimercaprol; Drug Therapy, Combination; Edema; Edetic Acid; Environmental Exposure; Foreign Bodies; Humans; Lead; Lead Poisoning; Male; Pica; Play and Playthings; Protoporphyrins; Seizures; Self-Injurious Behavior; Succimer; Wounds, Gunshot

Topics: Equipment Design; Foreign Bodies; Gastroscopes; Gastroscopy; Humans; Middle Aged; Pica; Radiography, Abdominal; Schizophrenia, Paranoid; Syndrome

A case of small bowel obstruction in a 4-year-old boy with pica is described. The child habitually chewed on his plastic toy action figures. Abdominal radiography and endoscopy confirmed the presence of chewed pieces of plastic within the digestive tract. At surgery, the cause of the obstruction was found to be an internal hernia involving a congenital fibrous band connecting 2 segments of the jejunum and unrelated to pica. Intestinal obstruction caused by foreign bodies is extremely rare, and obstruction caused by congenital bands is even more uncommon. This particular variant of a congenital band has not been previously described. Physicians should be aware that congenital bands can cause small bowel obstruction in children and that surgical treatment is required.

Topics: Abdominal Pain; Child, Preschool; Diagnosis, Differential; Foreign Bodies; Humans; Intestinal Obstruction; Jejunal Diseases; Jejunum; Male; Pica

The topic of foreign body ingestion has received extensive coverage in the areas of surgery, emergency medicine, and pediatrics. A subset of this topic, the intentional ingestion of foreign bodies, however, is much less common, and requires special evaluation and management. Here, we report a case of ingestion of a rolled, metal tuna can lid in a male prison inmate previously diagnosed with depression and paranoid schizophrenia. Following evaluation by the surgical team, the foreign body was removed by laparotomy and the patient was discharged back to the prison without complication. In many cases, ingestions of this type involve a command hallucination ordering the patient to swallow the foreign body. Interestingly, the patient in the present case reported auditory hallucinations commanding him not to swallow the can lid. On further investigation, we found that patient had a proclivity toward this swallowing behavior even prior to his incarceration. Early identification of inmates with this proclivity has important implications for treatment and prevention.

Topics: Adult; Depressive Disorder, Major; Foreign Bodies; Humans; Laparotomy; Male; Pica; Schizophrenia, Paranoid

We describe the thoracoscopic management of mediastinal sepsis and foreign body associated with a cervical oesophageal perforation. Following initially successful conservative management, the patient's condition worsened and we undertook surgical exploration where the abscess was drained and a fragment of china recovered.

Topics: Abscess; Drainage; Female; Foreign Bodies; Humans; Mediastinitis; Mediastinum; Middle Aged; Pica; Thoracic Surgery, Video-Assisted

Topics: Adult; Anemia, Sideroblastic; Blood Transfusion; Chelating Agents; Dimercaprol; Edetic Acid; Female; Foreign Bodies; Humans; Lead Poisoning; Pica; Schizophrenia; Sinus Thrombosis, Intracranial; Stomach

Topics: Copper; Esophagus; Foreign Bodies; Humans; Infant; Male; Pica; Radiography; Zinc

Topics: Abdomen, Acute; Adult; Diarrhea; Digestive System Surgical Procedures; Female; Foreign Bodies; Humans; Intestine, Small; Ischemia; Pica; Treatment Outcome; Vomiting

Topics: Acute Disease; Child; Colon; Diagnosis, Differential; Fecal Impaction; Female; Foreign Bodies; Fresh Water; Humans; Pica; Silicon Dioxide

Necrotizing enterocolitis (NEC) now is managed frequently successfully without surgical intervention. NEC may result in strictures, which present after the acute inflammatory process has resolved. Strictures usually present as obstruction in the first year or two of life. A case report is presented of an 11-year-old child who had symptoms from a previously undiagnosed NEC stricture as a result of pica when coins obstructed the stricture. As treatment of NEC continues to improve, more and later complications of this disease can be expected. J Pediatr Surg 36:1853-1854.

Topics: Child; Colectomy; Colon; Enterocolitis, Necrotizing; Female; Foreign Bodies; Humans; Intestinal Obstruction; Pica

We describe the case of a 27-year-old woman who in addition to the symptoms of factitious disorder showed deliberate ingestion of foreign objects. The relationship between secret and open self-destructive behavior is discussed. Analysis of situational factors highlights the importance of interactional background for the manifestation of impulsive self-harm. Parallels are pointed out to foreign body ingestion in institutionalized persons. Therapeutic issues are discussed.

Topics: Adult; Disruptive, Impulse Control, and Conduct Disorders; Factitious Disorders; Female; Foreign Bodies; Humans; Laparotomy; Physician-Patient Relations; Pica; Psychoanalytic Interpretation; Self-Injurious Behavior; Treatment Outcome

In humans, acquired copper deficiency anemia is rare. This report describes a 58-yr-old man with metal pica, especially coins, who presented with symptomatic anemia. His workup led to the diagnosis of zinc-induced copper deficiency. We believe that, in this man, leaching of zinc from pennies explained the clinical and laboratory findings. This case demonstrates that health care workers should consider the possibility of zinc-induced copper deficiency when confronted with patients with unexplained anemia who have ingested coins or other zinc-containing metals.

Topics: Bezoars; Copper; Foreign Bodies; Humans; Male; Middle Aged; Numismatics; Pica; Schizophrenia, Paranoid; Stomach; Zinc

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

To report experience with the treatment of complications of vinyl glove ingestion in mentally retarded patients with pica.. A retrospective case series.. Two university-affiliated hospitals.. Five mentally retarded patients, 4 with a history of pica, who were admitted for the management of complications resulting from the ingestion of vinyl gloves.. Type of complication, treatment and operative outcome.. The patients ranged in age from 26 to 46 years. One patient died while awaiting surgical consultation of massive gastrointestinal bleeding from a large gastric ulcer caused by a vinyl glove bezoar (VGB). Four VGBs were removed surgically. Endoscopic removal was difficult or impossible because the gloves had become hardened and matted.. VGB should be considered in institutionalized mentally retarded people with a history of pica when they present with gastrointestinal symptoms. VGBs should be removed directly by laparotomy, gastrotomy or enterotomy. Endoscopic removal is not recommended.

Topics: Adult; Bezoars; Female; Foreign Bodies; Gloves, Surgical; Humans; Intellectual Disability; Male; Middle Aged; Pica; Polyvinyls; Radiography

Topics: Abdominal Neoplasms; Anemia, Iron-Deficiency; Child; Diagnosis, Differential; Female; Foreign Bodies; Humans; Intestine, Large; Pica; Radiography

A case of severe lead poisoning following ingestion of an imported clothing accessory is reported. The child presented with abdominal pain, vomiting, and anemia but did not develop encephalopathy.. Prompt removal of the object in conjunction with whole bowel irrigation and chelation therapy led to a favorable outcome.

Topics: Child, Preschool; Clothing; Female; Foreign Bodies; Humans; Lead Poisoning; Pica; Radiography; Stomach

A 14-month-old girl presented with elevated lead levels and a metallic foreign body was detected on abdominal radiograph. Subsequent evaluation, performed after the child failed to pass the foreign body with cathartics, revealed a bezoar proximal to a partial duodenal obstruction. The metallic foreign body was later removed and found to contain lead, however, the patient has subsequently had recurrent elevations of lead levels with episodes of pica. This case reiterates the need to evaluate children with retained foreign bodies for lead poisoning due to associated pica. In addition, retained foreign bodies should point to possible congenital anomaly of the duodenum causing partial obstruction.

Topics: Diverticulum; Duodenal Diseases; Duodenal Obstruction; Duodenum; Female; Foreign Bodies; Humans; Infant; Lead; Pica; Radiography

The records of 261 prisoners who purposely ingested foreign bodies are analyzed retrospectively. The data include type, shape, and number of foreign bodies as well as localization, clinical repercussion, evolution of patients, and the treatment they received. Laparotomy was necessary in 41 cases (15.7%) due to severe complications like obstruction, hemorrhage or perforation. All of our patients operated on had an uneventful postoperative course, without mortality. In our series, there were patients with more than one episode of ingestion of foreign bodies and others who needed reoperation.

Topics: Adolescent; Adult; Foreign Bodies; Humans; Male; Middle Aged; Pica; Prisoners; Retrospective Studies

The case of a person with severe mental handicap whose pica became uncontrollable during episodes of depressive illness is described. Treatment of the depression with lofepramine markedly reduced the pica, and withdrawal of lofepramine led to recurrence. It is suggested that biological symptoms of depression should be monitored in people with severe mental handicap who show significant episodic worsening of long-standing repetitive behaviour.

Topics: Depressive Disorder; Dose-Response Relationship, Drug; Drug Administration Schedule; Foreign Bodies; Humans; Intellectual Disability; Intestines; Lofepramine; Male; Middle Aged; Pica; Recurrence; Self-Injurious Behavior; Social Behavior

To determine the risk of increased blood lead levels in children with aural, nasal, or gastrointestinal foreign bodies, the authors prospectively obtained venous blood lead and erythrocyte protoporphyrin levels from 40 study patients and two control groups without foreign bodies (65 patients presenting to a medical clinic and 40 patients presenting to an emergency department). A questionnaire was used to assess environmental and behavioral risk factors for lead poisoning in the three groups. Mean blood lead level was higher in children with foreign bodies (P less than .001), and they were more likely to have a venous blood lead value of more than 1.2 mumol/L (25 micrograms/dL, P less than .01) than patients in either control group. Seventy-eight percent of study patients had no prior lead screening by parent's report vs 64% of emergency department control subjects and 55% of medical clinic control subjects. Control patients in the emergency department had the same incidence of elevated blood lead values as patients enrolled from the medical clinic (6%). No differences in environmental risk factors were found among the three groups. Study patients more often had a history of pica or ingestion of a poison than control patients from the medical clinic. Inner-city children with foreign bodies have increased lead exposure and may have an increased risk for lead poisoning. In areas of high prevalence of lead poisoning, children with foreign bodies should be screened for lead poisoning in the emergency department. General lead screening in the emergency department may be justified for high-risk, inner-city populations.

Topics: Child, Preschool; Digestive System; Ear; Erythrocytes; Female; Foreign Bodies; Housing; Humans; Lead; Lead Poisoning; Male; Nose; Pica; Prevalence; Prospective Studies; Protoporphyrins; Risk Factors

Topics: Adjustment Disorders; Adolescent; Adult; Combined Modality Therapy; Digestive System; Foreign Bodies; Hallucinations; Homicide; Humans; Impulsive Behavior; Male; Personality Disorders; Pica; Prisoners; Schizophrenic Psychology; Suicide, Attempted; Violence

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

Topics: Adult; Foreign Bodies; Humans; Jejunum; Male; Pica; Schizophrenia, Paranoid; Stomach

In Prudhoe Hospital, a large mental-handicap hospital of 1000 residents, it was found that of the 94 deaths that occurred between 1982 and 1986, three were closely associated with the habit of pica. These deaths occurred in severely and profoundly handicapped males, whose average age was 32, compared with an average age of death of 58 for the combined groups of severely and profoundly mentally handicapped patients (22 cases), and an average age of death of 60 for all degrees of handicap (94 cases). It seems likely that the habit of pica constitutes a cause of considerable morbidity and mortality in certain institutionalised patients.

Topics: Adult; Death, Sudden; Esophagus; Foreign Bodies; Humans; Intellectual Disability; Male; Pica

Topics: Adolescent; Foreign Bodies; Humans; Intestinal Perforation; Intestines; Male; Pica

Pica was recognized in 25.8 percent of a population of 991 institutionalized mentally retarded adults. Food pica accounted for 5.4 percent, nonfood pica for 16.7 percent, and combination food and nonfood pica for 3.7 percent of the population. Pica became less frequent with increasing age, related to a reduction in the incidence of nonfood pica. Food pica was not age-related. Low IQ was associated with a high frequency of nonfood pica. The items consumed were classed into 29 nonfood and 7 food categories. Some medical complications such as intestinal obstruction and surgery secondary to foreign body ingestion occurred only in those with pica. Gastrointestinal parasites occurred more frequently in individuals with pica.

Topics: Adolescent; Adult; Aged; Child; Female; Foreign Bodies; Humans; Intellectual Disability; Intelligence; Male; Middle Aged; Pica; Seasons

Topics: Animals; Chickens; Foreign Bodies; Gizzard, Avian; Humans; Pica; Poultry Diseases

Topics: Child, Preschool; Digestive System; Feeding and Eating Disorders; Feeding Behavior; Foreign Bodies; Humans; Male; Pica; Urination Disorders

Topics: Bronchiectasis; Child; Cough; Foreign Bodies; Humans; Male; Pica; Poaceae

Topics: Anemia; Anemia, Hypochromic; Black People; Feeding and Eating Disorders; Foreign Bodies; Gastrointestinal Tract; Humans; Pica; Radiography; United States

Topics: Abdomen; Abdominal Cavity; Feeding and Eating Disorders; Foreign Bodies; Humans; India; Malingering; Pica; Radiography

Topics: Appetite; Arteries; Bezoars; Digestive System; Duodenum; Foreign Bodies; Humans; Mesentery; Pica