Geophagia: A rare cause of Intestinal Obstruction

Abstract

We report a 4-year-old male child, who presented with abdominal distension and absolute constipation for 4 days. The mother revealed that her child had been picking up sand and eating it for about a month prior to admission. The child was blind since birth and suffered from cerebral palsy and developmental retardation. Abdominal examination revealed a grossly distended abdomen, but no tenderness or guarding. The abdominal swelling had a doughy feel that was dull on percussion. Rectal digital examination revealed a solid sandy mass. Plain abdominal x-ray showed opacifications in both the large and small bowels. A diagnosis of intestinal obstruction due to geophagia was made. The patient was treated conservatively including rectal washouts. The obstruction was relieved and he started to pass normal stools on the 7th day. We discuss this rare case of intestinal obstruction due to geophagia. We review this feeding abnormality. We describe our management including our novel and simple rectal washout technique. The problems that occurred during the course of the treatment and the role of multidisciplinary approach are highlighted. Keywords : Pica; Bezoar; Rectal impaction; Rectal washout.