Intestinal obstruction in a mentally retarded patient due to pica.
Intestinal obstruction in a mentally retarded patient due to pica.
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DOI：
10.1186/s12991-015-0060-4
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发表时间：
2015
影响因子：
3.7
通讯作者：
Tsushima Y
中科院分区：
文献类型：
--
作者：
Tokue H;Takahashi Y;Hirasawa S;Awata S;Kobayashi S;Shimada T;Tokue A;Sano R;Kominato Y;Tsushima Y
一名40岁的弱智日本男子被送往残疾人康复中心，发现死在床上。他的新生儿期并发癫痫发作，他有精神分裂症病史。尸检计算机断层扫描显示肠梗阻，但原因不明。为了澄清死因，进行了法医尸检。发现胃肠道含有大量的布片。诊断为肠梗阻继发于异食癖的衣服。尽管精神发育迟滞仍然是一种基本上被忽视的疾病，但它对患者、其亲属和照顾者以及整个社会造成了重大负担。此外，患有精神发育迟滞的人由于摄入非食用物质或不一致地摄入食用物质而可能处于潜在的自我伤害的增加的风险中，这反过来可能导致严重的或甚至危及生命的医疗和手术并发症，如本文所报道的。因此，还应特别关注患有突发严重胃肠道事件的智力迟钝患者的异食癖，以防止潜在的死亡或其他严重的慢性后果，理想的目标是加强对那些心理压力或触发因素的早期识别和多学科管理。
A 40-year-old mentally retarded Japanese man was admitted at rehabilitation facility for handicapped persons and found dead in his bed. His neonatal period was complicated by seizures, and he had a medical history of schizophrenia. A postmortem computed tomography scan suggested an intestinal obstruction, but the cause was unknown. To clarify the cause of death, a medicolegal autopsy was carried out. The gastrointestinal tract was found to contain copious amounts of cloth pieces. A diagnosis of intestinal obstruction secondary to pica of clothes was made. Despite still being an essentially neglect condition; mental retardation is cause to significant burden to the patient, his relatives and caregivers and the whole society. Moreover, people with mental retardation may be at increased risk for potentially self-injury due to ingestion of non-eating substance or incongruent intake of eating substances, which may on turn lead to severe or even life-threatening medical and surgical complications as herein reported. Specific attention also to pica in mentally-retarded patients with sudden, severe, gastrointestinal events, should therefore be placed in order to prevent potential death or otherwise severe chronic consequences, ideally aiming at enhancing the early recognition and multi-disciplinary management of those psychological stressors or triggers potentially responsible for pica too.