Complications Of Pica: Case Report And Review Of Literature

摘要

Pica is an eating disorder in which a person repeatedly eats non-food items, a pattern, lasting for at least a month. Although it is a common disorder, however at times pica is detected only after developing some complications like gastrointestinal obstruction. It can result in intoxication, quadriparesis, rhabdomyolsis and also in death. Authors report a case of pica with total esophageal obstruction. The complications associated with pica are reviewed. Introduction Pica is an eating disorder typically defined as the persistent eating or mouthing of non-nutritive substances. It affects infants, children, mentally retarded persons and sometimes even adults 1 . The true incidence of pica is not known but it is estimated to be 75% in infants, 15% in two-three year old toddlers and 10-33% among the institutionalized mentally retarded children 2 . Pica may accompany a developmental disorder. Pica can occur during pregnancy or at the time of breast-feeding. Sometimes pica is recognized only when it results in a complication like the present case. Case Report A girl child aged 6 years presented in the emergency service with a history of ingestion of a stone about 8 hours ago. She complained of pain in the neck, inability to swallow, drooling of saliva and vomiting. Past history revealed history of eating clay and sand. On general physical examination the patient was anemic, conscious and well oriented. Oral, dental, respiratory and cardiovascular system examination was normal. Her Hb was 5 gms. X-ray chest with neck PA view revealed a radio-opaque shadow of size about 2.5 x 3.5 cm impacted in the esophagus just below the crico-pharyngeal sphincter (Fig 1).