Eating the Unthinkable: PICA-Induced Plastic Bezoar Causing Peritonitis-A Call for Community Based Prevention and Early Recognition of Childhood Anxiety
Abstract
Suchita Rajoria, Arihant Jain and Alka G. Grewal
Rapunzel syndrome is a rare condition where a bezoar extends from the stomach into the duodenum or distal small intestine. Bezoars are formed by the progressive accumulation of a nondegradable foreign body in the stomach. This case highlights the habit of ingesting nonnutritive substances in children (PICA) as the underlying reason for bezoar formation. We report a case of a 6-year-old male who presented with intestinal obstruction and, when operated on in an emergency setting, turned out to have a bezoar of plastic and kite wire threads with intestinal perforation. Bezoar was extracted via laparotomy, and resection-anastomosis was done to achieve a successful outcome. Notably, his siblings, rather than his parents, were more aware of his habit of chewing kite-flying threads, making it necessary to involve all family members in the counselling sessions irrespective of age. Thus, the comprehensive management of such complications needs the integration of surgical and psychological approaches to treat and prevent recurrence.