Abdominal panniculitis as a presentation of Munchausen Syndrome

摘要

Factitious disorders including Munchausen’s syn drome are encountered by all clinicians. A considerable number of cases of Munchausen’s syndrome are under-diagnosed in clinical practice. We present a 34-year-old man who was admitted with symptoms of epigastric pain, vomiting and peri-umbilical ecchymosis. Physical examination showed signs of inflammation in the abdominal wall with tenderness and guarding in the upper abdomen. However, various blood tests were unremarkable. Computed Tomography and demonstrated anterior abdominal wall panniculitis. After many investigations looking into various aetiological factors that could lead to fat necrosis, a diagnosis of Munchausen’s syndrome was made and the patient was discharged to the care of the local general doctor practice following psychiatric input.