27 Jul, 2016

SELF-EXTERMINATION ATTEMPTED THROUGH THE 128 NAILS INTAKE

Juliana L. LUSVARGHI
Marcelo C. FATURETO
DOI: 10.1590/0102-6720201600030020
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NTRODUCTION

Suicide is among the top ten causes of death in all age groups and with higher incidence between 15 and 35 years. Its incidence is increasing in young population7.

According to the World Health Organization, various stress conditions can increase the risk of suicide1. Eighty-five percent of patients who ingest foreign body have previous psychiatric illness and 84% of these patients have had previous intakes5.

From ingested foreign bodies 90% pass spontaneously through the gastrointestinal tract; 10-20% requires endoscopic removal; and 1% surgical approach6. In the general population, the foreign bodies are more often accidentally ingested such as bones, thorns or fruit stones. Most are housed in the physiological constrictions of the esophagus or abnormal narrowing sites (stenosis, rings or malignant tumors).

Here is presented one case of self-extermination attempt with continuous intake of nails in the course of a year.

CASE REPORT

Teenager of 16 year old was admitted with nails intake history during one year claiming attempt to self-extermination after constant arguments with his father and continuous nails intake. The parents were scavengers and had woodwork in which the patient had free access to the ingested material. Two days of admission he had epigastric pain, vomiting, and an episode of blackened stools. Physical examination showed good general condition, no collaborative, pallid (1+ / 4+), emaciated, heart beat 105 bpm, blood pressure of 120x80 mmHg, flat and flaccid abdomen, painful to deep palpation of epigastrium and no sudden pain to decompression. A large number of nails in the left iliac fossa was seen in abdominal radiograph (Figure 1); blood count was with leukocytosis and left shift.


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ABCD – BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY is a periodic with a single annual volume in continuous publication, official organ of the Brazilian College of Digestive Surgery - CBCD.

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