The hazards of vinyl glove ingestion in the mentally retarded patient with pica: new implications for surgical management.

OBJECTIVE To report experience with the treatment of complications of vinyl glove ingestion in mentally retarded patients with pica. DESIGN A retrospective case series. SETTING Two university-affiliated hospitals. PATIENTS Five mentally retarded patients, 4 with a history of pica, who were admitted for the management of complications resulting from the ingestion of vinyl gloves. MAIN OUTCOME MEASURES Type of complication, treatment and operative outcome. FINDINGS The patients ranged in age from 26 to 46 years. One patient died while awaiting surgical consultation of massive gastrointestinal bleeding from a large gastric ulcer caused by a vinyl glove bezoar (VGB). Four VGBs were removed surgically. Endoscopic removal was difficult or impossible because the gloves had become hardened and matted. CONCLUSIONS VGB should be considered in institutionalized mentally retarded people with a history of pica when they present with gastrointestinal symptoms. VGBs should be removed directly by laparotomy, gastrotomy or enterotomy. Endoscopic removal is not recommended.