Role of Radiology in Pica Syndrome: A Case Report

Pica syndrome is a mental disorder defined as eating non-food and not-nutritive substances at least for 1 month. The diagnosis of pica syndrome is based on severe anemia which is not compatible with the developmental level, intestinal obstructions, or several conditions depending on content of the substance intaken such as lead poisoning etc. The diagnosis of pica syndrome requires active involvement of pediatrics, psychiatrists, radiologists and patients/family members. In this report, we present a 50-year-old female patient who presented to the emergency department with abdominal pain and radiologically diagnosed with pica syndrome. Patient’s physical and laboratory investigations were normal, while all abdominal tomography revealed hyper-density areas. It was found in the detailed history of the patient that she was receiving psychiatric therapy and had habit of eating cigarette ashes. Upon this, cigarette ashes soaked in water were radiologically examined, similar hyper-density areas were found, and the diagnosis of pica syndrome was established. This case is the third case of eating cigarette ashes pica presented in the literature, and the first case diagnosed radiologically.

Keywords:

Pica syndrome, computed tomography, radiology eating disorders,

PDF

___

1. Rohde J, Claussen MC, Kuechenhoff B, Seifritz E, Schuepbach D. Combined symptomatology of psychosis, pica syndrome, and hippocampal sclerosis: a case report. Int J Eat Disord 2013; 46:89-91.
2. Ledford JR, Barton EE, Rigor MN, Stankiewicz KC, Chazin KT, Harbin ER et al. Functional Analysis and Treatment of Pica on a Preschool Playground. Behav Anal Pract 2018; 12:176-181
3. Bhatia MS and Kaur N. Pagophagia – A Common but Rarely Reported Form of Pica. J Clin Diagn Res 2014; 8: 195–196.
4. Stroman D, Young C, Rubano AR, Pinkhasov A. Adult-Onset Pica Leading to Acute Intestinal Obstruction. Psychosomatics 2011; 52:393-4.
5. Asma S. An iron deficiency anemia and a different pica substance: a case report. Türk Aile Hek Derg 2009; 13: 159-161.
6. Grewal P, Fitzgerald B. Pica with learning disability. J R Soc Med 2002; 95:39-40.
7. Jawed SH, Krishnan VH, Prasher VP, Corbett JA. Worsening of pica as a symptom of depressive illness in a person with severe mental handicap. Br J Psychiatry 1993; 162:835-7.
8. Desilva R. Eating Cigarette Ashes in Anemia. Ann Intern Med 1974;80:115-116.
9. Aoyagi T, Hayakawa H, Matsumoto M, Ishikawa H. Eating Cigarette Ashes Pica in a Patient with Chronic Renal Failure. Japanese Journal of Clinical Urology 2000; 54:334-335.