Intentional Foreign Body Ingestion: A Complex Case of Pica

Intentional ingestion of foreign objects, a form of self-injurious behavior, is rarely discussed in the medical literature but often requires extensive evaluation, management, and resources. It can be especially problematic for gastroenterologists, who are often consulted for removal of the foreign body. Pica is the psychiatric diagnosis for intentional ingestion of nonnutritive objects and is most commonly seen in prison inmates and those diagnosed with intellectual disability or psychiatric illness. This case report presents a challenging case of pica, highlighting the complexity involved in diagnosis and the need for early psychiatric intervention. It also aims to provide a general review of the literature and practical recommendations to assist with managing this form of self-injurious behavior in the inpatient setting. Collaborative efforts among specialties in addition to primary prevention are vital to successful management of these patients.

[1]  Aaas News,et al.  Book Reviews , 1893, Buffalo Medical and Surgical Journal.

[2]  R. Sarpong,et al.  Bio-inspired synthesis of xishacorenes A, B, and C, and a new congener from fuscol† †Electronic supplementary information (ESI) available. See DOI: 10.1039/c9sc02572c , 2019, Chemical science.

[3]  O. Boyko,et al.  Nonsuicidal self-injury-related foreign bodies in the emergency department. , 2015, Seminars in ultrasound, CT, and MR.

[4]  R. Mishori,et al.  Pica: an age-old eating disorder that's often missed. , 2014, The Journal of family practice.

[5]  H. Hattori,et al.  Unclassified cases of behavioral variant of major frontotemporal neurocognitive disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition , 2014, Geriatrics & gerontology international.

[6]  S. Bergese,et al.  Intentional foreign object ingestions: need for endoscopy and surgery. , 2013, The Journal of surgical research.

[7]  J. Matson,et al.  Pica in persons with developmental disabilities: approaches to treatment. , 2013, Research in developmental disabilities.

[8]  K. Mullen,et al.  Recurrent Intentional Foreign Body Ingestion: An Endoscopist's Dilemma. , 2012, Gastroenterology & hepatology.

[9]  J. Hunter,et al.  Hard to swallow: a systematic review of deliberate foreign body ingestion. , 2011, General hospital psychiatry.

[10]  Brian L. Huang,et al.  Intentional swallowing of foreign bodies is a recurrent and costly problem that rarely causes endoscopy complications. , 2010, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[11]  M. Ohlmeier,et al.  Swallowing foreign bodies as an example of impulse control disorder in a patient with intellectual disabilities: a case report. , 2010, Psychiatry (Edgmont (Pa. : Township)).

[12]  L. Laine,et al.  Foreign-body ingestion: characteristics and outcomes in a lower socioeconomic population with predominantly intentional ingestion. , 2009, Gastrointestinal endoscopy.

[13]  Ravi Gupta,et al.  Pica responding to SSRI: An OCD spectrum disorder? , 2009, The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry.

[14]  Jason P. Caplan,et al.  Foreign-body ingestion in patients with personality disorders. , 2007, Psychosomatics.

[15]  D. Devanand,et al.  Pica in the Geriatric Mentally Ill: Unrelenting and Potentially Fatal , 2003, Journal of geriatric psychiatry and neurology.

[16]  D. Stein,et al.  Pica and the obsessive-compulsive spectrum disorders. , 1996, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[17]  W. Hager,et al.  and s , 2019, Shallow Water Hydraulics.

[18]  R. Kumar,et al.  Pica and Psychosis – Clinical Attributes and Correlations: A Case Report , 2015, Journal of family medicine and primary care.