Serap AYDEMİR DİKİCİ, Emin UYSAL, Hatice KARAÇAM

Nadir bir munchausen sendromu olgusu: yabancı cisim yutulması

Munchausen Sendromu (MS), hastalar tarafından kasıtlı olarak üretilen zihinsel veya fiziksel hastalıklarla karakterizedir. Bu olgu sunumunda MS'i sunmayı ve güncel literatürü gözden geçirmeyi amaçladık. 36 yaşındaki kadın hasta, dikiş iğneleri yutma sonrası gelişen karın ağrısı şikâyetiyle acil servise başvurdu. Fizik muayenede palpasyonla batında minimal hassasiyet vardı. Çekilen ayakta direkt batın grafisinde ondan fazla iğne şeklinde opasite mevcuttu. Hastanın anamnezinde tutarsızlıklar ve cerrahi girişim için aşırı istekli olması MS şüphesini uyandırdı. Psikiyatri konsültasyonu istendi, MS tanısıyla yatışı planlandı. Klinik şüphe ve ayrıntılı anamnez, tanı için anahtardır. Hekimler, hastaneye sık başvuran, şikâyetleri ile öykü ve muayene bulguları arasında uyumsuzluk olan hastalarda MS tanısını akla getirmeli ve psikiyatrik destek almalıdır.

A rare case of Munchausen syndrome: foreign body ingestion

Munchausen Syndrome (MS) is characterized by mental or physical diseasesintentionally induced by the patients. In this case report, we aimed to present MS andreview current literature. A 36-year-old female patient was admitted to the emergencyroom with the complaint of abdominal pain that developed after swallowing stitchneedles. Physical examination revealed minimal tenderness in the abdomen withpalpation. The plain abdominal X-ray revealed more than ten needle-shapedopacities. During the anamnesis, the patient was incoherent and too determined tohave a surgical intervention, which gave rise to a suspicion of MS. A psychiatristconsultation was conducted, she was diagnosed with MS and hospitalization of thepatient was planned. Clinical suspicion and detailed anamnesis are the key for thediagnosis. Physicians should bring to mind the diagnosis of MS and seek psychiatricsupport in patients with frequent hospital admissions, incompatibility between theircomplaints and a history and examination findings.

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1. Turner J, Reid S. Munchausen’s syndrome. Lancet. 2002;359;(9303):346-9. PMID: 11830219
2. Lin JL, Servat JJ, Bernardino CR, Goldberg RA, Levin F. Bilateral korneal perforations and autoproptosis as self-induced manifestations of ocular munchausen’s syndrome. Orbit. 2012;31(4):252-5. PMID: 22571651
3. Keleş S, Öndaş O, Dursun OB, Pınar CL, Ateş O. Ocular Munchausen Syndrome; Self Introduction of Clay and Glass Parts to Conjunctival Fornix. J Clin Anal Med. 2014;5(2):209-11. DOI: 10.4328/jcam.3124
4. Lazzeri D, Romeo G, De Rossa M, Iannotti G, Colizzi L, Stabile M, et al. Plastic surgery and Munchausen’s syndrome ‘surgeon beware!. J Plast Reconstr Aesthet Surg. 2010;63(3):319-20. PMID: 19604739
5. Lauwers R, Winkel NVD, Vanderbruggen N, Hubloue I. Munchausen syndrome in the emergency department mostly difficult, sometimes easy to diagnose: a case report and review of the literature. World J Emerg Surg. 2009;4-38. PMID: 19909508
6. Livaoglu M, Kerimoglu S, Hocaoglu C, Arvas L, Karacal N. Munchausen’s syndrome: a rare self-mutilation syndrome. Dermatol Surg. 2008;34(9):1288-91. PMID: 18616542
7. Gözlükaya A. A Case of Munchausen Syndrome Admitting With Hemorrhage. Akademik Acil Tıp Olgu Sunumları Dergisi. 2010;1(1):47-9.
8. Demiralp CÖ, Akkaya H, Duman Y, Akşam B, Demirseren ME. A Rare Case Presenting With Complaints Of Foreign Body On Scalp: Munchausen Syndrome. Ankara Medical Journal. 2012;12(2):106-8.