Trastorno psiquiátrico asociado a una conducta reiterada de ingesta de cuerpos extraños. Pautas de manejo

Abstract

Introduction. Foreign body ingestion (FBI) usually occurs accidentally. The 70-80% of the cases occur in children with ages between 6 months and 3 years. Cases. The aim of this original article is present a case series of 4 patients with history of psychiatric disorders, all of whom are residents of the same institution, and who repeatedly perform FBI with self-injurious purposes. The treatment was different according to the episodes, from expectant management with radiological control in most of the cases, and upper digestive endoscopy until the finally surgical treatment. Discussion. Most of the objects use to be small inorganic objects such as piles, buttons, coins and pieces of toys. In adult patients, the objects are usually organics like bones, fish bones or food bowls. The most fragile are usually the elderly with dental prostheses ingestion. There is a special group, those patients who ingest voluntarily for different purposes. In one hand patients who have an intellectual disability, mental illness and / or substance abuse disorder, on the other hand, those who do it with economic purposes, also so-called «mules». The symptoms, complications and management depend on the object itself, evolution and anatomic localization. Conclusion. The clinical performance is difficult because there is no protocoled management established currently to prevent, treat and most important, avoiding new episodes.