title: Recurrent cholecystitis in an elderly mentally retarded patient with pica.
abstract: The case of a 64-year-old patient with pica and severe mental retardation who was admitted to our hospital for treatment of recurrent cholecystitis is reported. Abdominal ultrasound showed sludge in the gallbladder, but no stones. Abdominal CT revealed a foreign body in the duodenum resembling a suction cup of the type commonly used in kitchens and bathrooms. The object could not be removed because it was deeply embedded in the hypertrophic intestinal mucosa. A nasogastric tube was inserted for feeding, since the object impeded the passage of solid foods. The patient's fever and abdominal pain subsequently resolved, and laboratory data improved. The indwelling feeding tube prevented recurrence of cholecystitis. Since pica is common not only in patients with mental retardation but also in dementia patients, the present case may also relate to the treatment of acute abdominal conditions in dementia patients.
authors.affiliation: Department of Psychiatry, Juntendo University School of Medicine, Juntendo University Nerima Hospital, Tokyo Japan. k-miyakawa@juntendo-urayasu.jp
authors.forename: Koichi
authors.initials: K
authors.lastname: Miyakawa
authors.forename: Masanobu
authors.initials: M
authors.lastname: Ito
authors.forename: Kotaro
authors.initials: K
authors.lastname: Hatta
authors.forename: Ko
authors.initials: K
authors.lastname: Eto
authors.forename: Heii
authors.initials: H
authors.lastname: Arai
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000628:therapy; D002764:Cholecystitis / Q000209:etiology* / Q000628:therapy; D004386:Duodenum / Q000000981:diagnostic imaging; D005260:Female; D005334:Fever / Q000209:etiology / Q000628:therapy; D005547:Foreign Bodies / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008607:Intellectual Disability / Q000150:complications*; D007441:Intubation, Gastrointestinal / Q000379:methods; D008875:Middle Aged; D010842:Pica / Q000150:complications*; D012008:Recurrence; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome