pica and Peritonitis

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

Children and adolescents with sickle cell disease demonstrate an increased incidence of pica. Pica involving polyurethane foam has been previously reported, but effective management of such cases remains unclear. We present the case of a 17-year-old African American adolescent girl with sickle β+ thalassemia who presented with a long history of foam rubber pica resulting in intestinal obstruction. Conservative management was unsuccessful, and the patient ultimately required operative intervention. We advocate for a low threshold for early operation in cases of foam rubber bezoar.

Topics: Abdominal Pain; Adolescent; beta-Thalassemia; Bezoars; Depression; Female; Heterozygote; Humans; Ileal Diseases; Ileum; Intestinal Perforation; Peritonitis; Pica; Polyurethanes; Radiography; Sickle Cell Trait; Zinc

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

Topics: Female; Humans; Intestinal Perforation; Middle Aged; Peritonitis; Pica; Sigmoid Diseases