PA29 PRESUMPTIVE SAFETY FOR CELIAC PATIENTS OF WHEAT BAKED GOODS RENDERED GLUTEN-FREE DURING SOURDOUGH FERMENTATION

Abstract

After several interviews, this teenager admitted participation to an unusual dietary party with three peers, 4 days before admission. They ate a “soup” formed by gravel, wheat flour and water, for slimming purposes. The soup recipe had been found on an unidentified web site. After the party, one of the friends underwent emergency appendectomy for appendix occlusion caused by a gravel stone, another had been admitted for acute abdominal pain followed by passage of gravel stones in the stool while the third eliminated the stones in the stools without any complaint. Discussion: This case-report highlights the risks related to improper use of uncontrolled information found on the internet. There is a rising and widespread use of the web among children and adolescents. Recent studies showed that adolescents disclose personal information and may display risky behaviour. Sylvia wanted to loose weight even though her BMI was normal (18.7 = 25th percentile for age and gender). Concerns about weight, body shape and dieting are common among adolescent girls and may represent risk factors for eating disorders. One’s body image perception is influenced by several factors, including personal, parental and friends’ judgement, sociocultural environment and media pressures, that are believed to encourage the development of an unrealistically thin ideal of body shape. Independent of age and BMI, parental and media influences on adolescents are predictive of becoming highly concerned with weight and a constant dieter. Abdominal ultrasound is usually the first-line (and often the only) imaging investigation performed in the diagnostic process of children with AAP, to exclude appendicitis or other surgical conditions (e.g. intussusception). Abdominal ultrasound has however limitations (e.g. presence of excessive intestinal gas and operator dependence) and does not always identify ingested foreign bodies. In this patient, the intestinal stones were indeed detected only by a standard abdominal x-ray. Conclusions: Acute or recurrent abdominal pain is a frequent complaint in adolescents, particularly of those experiencing emotional and socio-familial difficulties. A careful interview can help to identify risky behaviours that could be responsible for this distressing disorder. As suggested by this case-report, the use of junk information retrieved by uncontrolled internet sources should be investigated. The deliberate ingestion of foreign bodies is a possible cause of AAP in teenagers.