Premium
A Review of the Forensic Implications of Pica
Author(s) -
Byard Roger W.
Publication year - 2014
Publication title -
journal of forensic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.715
H-Index - 96
eISSN - 1556-4029
pISSN - 0022-1198
DOI - 10.1111/1556-4029.12520
Subject(s) - pica (typography) , medicine , peritonitis , perforation , vomiting , volvulus , sepsis , diarrhea , fecal impaction , autopsy , surgery , pediatrics , constipation , materials science , world wide web , computer science , punching , metallurgy
Pica is characterized by the persistent eating of non‐nutritive substances over some time that is inappropriate for the maturation stage of the individual and is not culturally sanctioned. A 9‐year‐old boy with G oldenhar syndrome, significant developmental delay and pica, collapsed and died after a short history of diarrhea and vomiting. Death was due to a sigmoid volvulus resulting from filling of the distal colon with feces containing dirt, stones, and rice with evidence of ischemic intestinal necrosis. Lethal complications of pica include intestinal obstruction and perforation with peritonitis and generalized sepsis. Other findings at autopsy may include airway obstruction, heavy metal poisoning, and parasitic infestation. Presenting symptoms and signs of such complications may be subtle or masked given the nature of underlying conditions, and so careful evaluation of the medical histories of individuals with pica may be necessary to provide pertinent details of associated medical and psychiatric conditions.