Pica, constipation and cardiorespiratory arrest.

Mourato Nunes I, et al. BMJ Case Rep 2017. doi:10.1136/bcr-2017-221066 Description Pica is an eating disorder typically defined as the persistent ingestion of non-nutritive substances, for at least 1 month, at an age of which this behaviour is inappropriate. It may be benign or may have life-threatening consequences. 2 The clinical presentation is highly variable and is associated with the specific nature of the resulting medical conditions and the ingested substances. The signs and symptoms can be from toxic, infectious, dental or gastrointestinal conditions. The authors present a clinical case of a 61-year-old man with clinical history of cognitive impairment and pica, admitted in an intensive care unit after cardiorespiratory arrest. The initial hospital admission was for constipation and abdominal pain. Abdominal and pelvic CT scan revealed ‘significant colonic dilatation with a sigmoid size of 14.5 cm, with evidence of abundant intraluminal faecal content at this level—aspects suggestive of translating obstructive process by faecaloma, visualising bone and metallic contents inside’. A rectal touch was performed with extraction of abundant faeces and foreign bodies (bones and screws). After abundant excretion, he had bradycardia with haemodynamic instability