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吞咽异物作为智力障碍患者冲动控制障碍的一个例子:病例报告

Swallowing foreign bodies as an example of impulse control disorder in a patient with intellectual disabilities: a case report.

作者信息

Te Wildt Bert T, Tettenborn Christian, Schneider Udo, Ohlmeier Martin D, Zedler Markus, Zakhalev Roman, Krueger Martin

机构信息

Hannover Medical School, Hannover, Germany, USA.

出版信息

Psychiatry (Edgmont). 2010 Sep;7(9):34-7.

Abstract

Objective. Foreign body ingestion can be a challenge to multiprofessional approaches involving medical, surgical, neurological, and psychiatric teams.Case presentation. A 41-year-old male patient with intellectual disabilities presented after having swallowed approximately 20 sharp objects. While admitted to a psychiatric ward, surgeons removed a glove from his stomach endoscopically and pharmacologically facilitated the objects' complication-free bowel passage. The patient explained the swallowing as a means to release himself from tension induced by stress. His aberrant behavior also seemed to serve as a means to exert pressure on psychosocial workers. Other deviations included the pushing of sharp objects under the skin and multiple paraphiliae. As a child, the patient suffered from early psychological and physical traumatization. Both parents were allegedly physically abusive alcoholics.Conclusion. Apart from possible alcohol embryopathy and traumatic brain damage, meningitis, which the patient had at the age of three, is discussed as the most likely reason for his oligophrenia, associated with left-sided, temporo-parietal atrophy and epilepsy.

摘要

目的。异物摄入对于涉及医学、外科、神经科和精神科团队的多专业治疗方法而言可能是一项挑战。

病例介绍。一名41岁的智障男性患者在吞下约20个尖锐物体后前来就诊。在入住精神科病房期间,外科医生通过内镜从他的胃中取出了一只手套,并通过药物促进这些物体顺利通过肠道。患者将吞咽解释为一种缓解压力所致紧张情绪的方式。他的异常行为似乎也是向心理社会工作者施压的一种手段。其他偏差行为包括将尖锐物体刺入皮肤以及多种性癖好。患者童年时遭受过早期心理和身体创伤。据称其父母均为有身体虐待行为的酗酒者。

结论。除了可能的酒精性胚胎病和创伤性脑损伤外,患者三岁时患有的脑膜炎被认为是其智力发育迟缓最可能的原因,这与左侧颞顶叶萎缩和癫痫有关。

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