Intentional Foreign Body Ingestion: A Complex Case of Pica

Abstract

Intentional ingestion of foreign objects, a form of self-injurious behavior, is rarely discussed in the medical literature but often requires extensive evaluation, management, and resources. It can be especially problematic for gastroenterologists, who are often consulted for removal of the foreign body. Pica is the psychiatric diagnosis for intentional ingestion of nonnutritive objects and is most commonly seen in prison inmates and those diagnosed with intellectual disability or psychiatric illness. This case report presents a challenging case of pica, highlighting the complexity involved in diagnosis and the need for early psychiatric intervention. It also aims to provide a general review of the literature and practical recommendations to assist with managing this form of self-injurious behavior in the inpatient setting. Collaborative efforts among specialties in addition to primary prevention are vital to successful management of these patients.

Differences between intentional and accidental ingestion of foreign body in China

“…However, there are no reports which focus on Chinese patients who intentionally ingest FBs. In adults, intentional ingestion of FBs commonly occurs among those with psychiatric disorders, pica and prisoners [7,8]. In our report, the number of patients who intentionally ingested FBs was not large, but the characters of these patients were very different from those who accidentally ingested FBs.…”

Intentional Foreign Body Ingestions: A Complex, Recurrent and Costly Issue

“…The literature on preventative strategies for RFIB ingestion among individuals in prison is scarce. Recent reports have proposed strategies that may mitigate RIFB ingestion, such as the removal of potentially ingestible objects from the patient’s room and specialized prison units for close monitoring [ 22 ]. Early consultation with psychiatry is likely beneficial to address underlying psychosocial conditions and may limit the escalation of self-harming behaviors.…”

Appetite for destruction: Food-related experiences of incarcerated children and young people

“…names resident] Dallas: Yeah. He'd eat this table Indeed, there have been several, documented situations where young people in KTYJC found themselves admitted to or detained in hospital on account of eating non-food items, which is recognised as a chronic problem in prison populations (Evans et al, 2015;Guinan et al 2019). This raises, in central fashion, the question of the adequacy of mental health services in custodial settings and, more squarely, what custody is or could be used for.…”