2019 Volume 40 Issue 2 Pages 169-173
Pica is a disorder that causes patients to repeatedly eat non-nutritional, non-food substances for at least one month. Pica is often complicated by intellectual disability, autism spectrum disorder, schizophrenia, and similar diseases. Here, we report a case of suspected esophageal obstruction due to pica found at a regular dental medical checkup. We describe the confirmation of the foreign body by endoscopy and its removal.
The patient was a 38-year-old man with intellectual disability and pica who lives in a support facility for persons with disabilities. During the course of ten days, he repeatedly had fever and was suspected of having an obstructed esophagus caused by foreign matter as he was in a state of oral intake disorder. As a result of an emergency endoscopic examination, foreign bodies were found at the entrance of the esophagus and were subsequently removed with forceps. Immediately after the procedure, the patient showed dish-eating behavior, so we conducted a total inspection and repair of the residential facility. Intellectually disabled people often raise no complaints of obvious subjective symptoms, are uncooperative, and sometimes cannot be examined without applying physical restraint. It can also be difficult to examine the patients for gastrointestinal foreign matter. To prevent serious complications, it is necessary to share information on pica patients with staff.
