title: Intestinal obstruction in a mentally retarded patient due to pica.
abstract: A 40-year-old mentally retarded Japanese man was admitted at rehabilitation facility for handicapped persons and found dead in his bed. His neonatal period was complicated by seizures, and he had a medical history of schizophrenia. A postmortem computed tomography scan suggested an intestinal obstruction, but the cause was unknown. To clarify the cause of death, a medicolegal autopsy was carried out. The gastrointestinal tract was found to contain copious amounts of cloth pieces. A diagnosis of intestinal obstruction secondary to pica of clothes was made. Despite still being an essentially neglect condition; mental retardation is cause to significant burden to the patient, his relatives and caregivers and the whole society. Moreover, people with mental retardation may be at increased risk for potentially self-injury due to ingestion of non-eating substance or incongruent intake of eating substances, which may on turn lead to severe or even life-threatening medical and surgical complications as herein reported. Specific attention also to pica in mentally-retarded patients with sudden, severe, gastrointestinal events, should therefore be placed in order to prevent potential death or otherwise severe chronic consequences, ideally aiming at enhancing the early recognition and multi-disciplinary management of those psychological stressors or triggers potentially responsible for pica too.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tokue
authors.affiliation: Department of Legal Medicine, Gunma University Hospital, Maebashi, Gunma Japan.
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Diagnostic and Interventional Radiology, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hirasawa
authors.affiliation: Department of Diagnostic and Interventional Radiology, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Awata
authors.affiliation: Department of Diagnostic and Interventional Radiology, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Kobayashi
authors.affiliation: Department of Diagnostic and Interventional Radiology, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Shimada
authors.affiliation: Department of Diagnostic and Interventional Radiology, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 Japan.
authors.forename: Azusa
authors.initials: A
authors.lastname: Tokue
authors.affiliation: Department of Legal Medicine, Gunma University Hospital, Maebashi, Gunma Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Sano
authors.affiliation: Department of Legal Medicine, Gunma University Hospital, Maebashi, Gunma Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kominato
authors.affiliation: Department of Diagnostic and Interventional Radiology, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511 Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Tsushima
keywords: Autopsy imaging; Intestinal obstruction; Mental retardation; Pica; Postmortem computed tomography