Munchausen's syndrome: gynecologic trauma with Stanley-knife blades

Abstract

We recently encountered a 21-year-old single, nulliparous woman who presented with vaginal pain and a raised body mass index. Pelvic examination failed because of pain and difficulty inserting a speculum. Radiography revealed two Stanley-knife blades in the pelvic region (Fig. 1). These were removed from the vagina under general anaesthesia, to reveal an intact vagina. She opted for early discharge, only to re-present two days later with another pair of Stanley-knife blades in the same location. Removal was again easy. She was transferred to psychiatric care, but discharged herself the following day after she was recognized by a doctor from another hospital where she had presented several times with similar complaints, receiving various unnecessary treatments. She declined expert help and defaulted from follow-up. Munchausen’s syndrome owes its name to Baron von Munchausen, the 18th century Ger-