A complicated case of bowel obstruction with sepsis and methamphetamine toxicity in a child with pica
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In this report, a pediatric case of bowel obstruction with sepsis complicated by methamphetamine toxicity is described. The decedent, an eleven-year-old female with a clinical history of pica, was found unresponsive in her home and pronounced dead following unsuccessful resuscitative efforts. Radiologic imaging showed multiple radio-opaque foreign objects in the stomach and bowel. Autopsy revealed a green leafy substance, coins and other metallic items, folded paper, and plastic in her stomach and bowels. Postmortem iliac blood and urine tested positive for amphetamine and methamphetamine. While the decedent’s medical history and autopsy findings provided evidence consistent with bowel obstruction with sepsis due to the ingestion of foreign materials, the high methamphetamine concentration was suggestive of concurrent methamphetamine toxicity. Unique complications associated with this case include the phenomenon that methamphetamine toxicity and bowel obstruction can present similarly in children and the reported opinion that accidental drug ingestion is uncommon in children over the age of five. This case emphasizes that the age range for suspected accidental drug ingestion should be expanded for those with pica, as these patients, despite being older, may not be able to differentiate between what they should and should not ingest. Furthermore, when treating a pediatric patient with pica that appears to present with bowel obstruction, unintentional drug ingestion should also be considered, particularly if there is a suspicion that the child lives in a household where drugs are abused, given the prospect that drug toxicity can present similarly.
KeywordsPica Pediatric methamphetamine Accidental overdose Adolescent methamphetamine Pediatric bowel obstruction Pediatric sepsis
Compliance with ethical standards
The authors individually declare that to the best of their knowledge and belief, a relationship, financial or otherwise does not exist which represents or may be perceived as representing a conflict of interest regarding the submitted manuscript. This manuscript does not contain any studies with human or animal subjects.
- 1.Hunt D, Kuck S, Truitt L. Methamphetamine use: lessons learned. Cambridge: Abt Associates Inc; 2005.Google Scholar
- 6.Hartmann AS, Poulain T, Vogel M, et al. Prevalence of pica and rumination behaviours in German children aged 7-14 and their associations with feeding, eating, and general psychopathology: a population-based study. Eur Child Adolesc Psychiatry. 2018. https://doi.org/10.1007/s00787-018-1153-9.
- 17.Gummin DD, Mowry JB, Spyker DA, Brooks DE, Fraser MO, Banner W. 2016 annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 34th annual report. Clin Toxicol. 2017;55(10).Google Scholar