Abstract
Sometimes we encounter case reports on pica in mentally retarded or dementia individuals. Recently we have experienced a case of pica developed small bowel obstruction and perforation by eating polyvinyl gloves where surgical operation was required.
A 17-year-old man who had had mental retardation since he was born visited a neighboring hospital because of the abrupt onset of vomiting and was diagnosed with enteritis. No symptomatic remission, however, was gained and abdominal pain developed as well. On the next day he presented to our hospital. An abdominal plain CT scan showed a low density mass about 50 mm in diameter in the ileum, which was suspected to be a foreign body. He had a previous history of pica when he ate cotton stuffed in “Futon”, so that the foreign body was likely to be cotton of Futon. We expected that the foreign body might be excreted spontaneously and decided to follow the clinical course. Symptomatic remission could not be gained during a 7-day observation after admission. We thus performed operation. Laparoscopic observation revealed obstruction at the ileum, into which the foreign body had impacted. Thinning of the bowel wall was seen, suggesting perforation. A small incision of the abdominal wall was made and partial resection of the small bowel was performed. The foreign body was clarified to be two polyvinyl gloves which formed a mass. Although the patient developed bowel paralysis and surgical wound infection, he was discharged from the hospital on the 28th postoperative day.
