Recently, the Digestive Surgery Center - Bach Mai Hospital has performed surgery on a patient who swallowed many foreign objects causing intestinal perforation. The patient was diagnosed with Pica syndrome, also known as the syndrome of liking to eat non-food objects.
50-year-old male patient, no relatives living with him. History of schizophrenia for 26 years, regular treatment at Nam Dinh Provincial General Hospital.
According to the patient's family, 2 weeks before being admitted to the hospital, the patient swallowed 3 lighters and had an endoscopy to remove the foreign object. This time, the patient was admitted to the hospital again because of increasing abdominal pain and bloating. Through clinical examination, the abdomen was found to be distended, with pain in the lower abdomen and a strong reaction.
Dr. Le Van Duy - Digestive Surgery Center, Bach Mai Hospital - said: Abdominal CT scan showed images of 2 metal-tipped rod-shaped foreign objects in the intestinal loop in the lower abdomen, penetrating the intestinal wall to create an air pocket in the pelvis next to the right obturator muscle; Foreign objects in the right hypochondrium intestinal loop; Thickening of the rectal wall, sigmoid colon and intestinal loop across the umbilicus; Diffuse dilation of the small intestinal loops.
The patient underwent emergency surgery: opening the small intestine to remove the foreign object (ballpoint pen, pen refill, plastic toothpick), cutting the segment of the sigmoid colon that was punctured by the foreign object, closing the lower end, and bringing the upper end out of the abdominal cavity to create an artificial anus.
After surgery, the patient is stable and will have to undergo another surgery to close the colostomy and restore the digestive tract. Prevention and monitoring of the patient is an issue after surgery to avoid recurrence of foreign body ingestion. If it happens again, it will be very difficult to handle.
According to Dr. Duy, Pica, an eating disorder, has been recognized for a long time. The term "pica" comes from Latin, meaning magpie (also known as Pica bird), because this bird has an omnivorous eating habit (from insects to grains, seeds, fruits, to eggs, chicks, rodents) and even things that are not normal food.
The disease was mentioned as early as the 14th century in medical literature, but it was not until the 18th century that it was more fully described and officially named.
Patients should be examined by a specialist (such as a psychiatrist, pediatrician, or psychologist) to determine the cause of the illness and rule out other diseases. This helps to choose the appropriate treatment.
Pica is diagnosed based on the following criteria:
- Eating non-food materials (such as soil, gravel, hair, paper, soap, or other objects) over a long period of time (usually lasting longer than a month).
- Not part of the culture or normal eating habits.
- This behavior cannot be explained by another medical condition (such as nutritional deficiency, psychological illness).
- During examination, the patient may not admit to this behavior or be unaware of its harmful effects, such as poisoning or damage to the digestive system.
Diagnosis of pica is mainly based on clinical signs and history, combined with paraclinical tests when necessary (such as blood tests, testing for nutritional deficiencies, or digestive function tests).
