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Patient with a PICA disorder requiring surgery: A case
report Case Summary: Pica is a pathologic craving for substances not commonly regarded as foods such as, clay, dirt, sand, stones, pebbles, hair etc. In some societies, pica is a culturally sanctioned practice and is not considered to be pathologic. Pica is common in patients with iron deficiency anemia. Pica may be benign, or it may have life-threatening consequences. Complications that need an open surgery are just few cases (about 1%). In this case study the authors report a 4 years old female child who presented on 25/11/02 to the emergency department of the Halibet national referral hospital with a history of ingestion of small stones, constipation and severe abdominal pain. On physical examination there was palpable irregular hard mass with severe tenderness on the right lower quadrant of the abdomen and stone concretion on PR exam plain film of the abdomen showed “a barium enema like” picture and the hematological profile was consistent with iron deficiency anemia. After a failed attempt of manual evacuation of the stone concretion lower abdominal midline incision was performed and the foreign body removed via an enterotomy. Post operation course was smooth the patient discharged improved. The case was compared, discussed and recommendation made. |
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