患者患有身体完整性认同障碍，自行实施断手但未进行再植：病例报告。
Self-Inflicted Hand Amputation without Replantation in a Patient with Body Integrity Identity Disorder: A Case Report.
机构信息
Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts.
Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts.
出版信息
JBJS Case Connect. 2021 Jul 6;11(3):01709767-202109000-00005. doi: e20.00976.
CASE
We describe a patient who self-amputated his hand using a log splitter, because of a long-standing belief that the limb "did not belong to him." On admission, he refused replantation and was found to be nonpsychotic. He was diagnosed with body integrity identity disorder (BIID) and declared competent to make his own medical decisions. A revision amputation was performed.
CONCLUSION
BIID is a challenging diagnosis that physicians treating traumatic injuries should be aware of. Many ethicists support elective amputation as a definitive treatment, because of potential harm reduction and because BIID does not respond to conservative modalities such as pharmacotherapy.
案例
我们描述了一位患者，他使用原木劈裂机自行截断了自己的手，因为他长期以来一直坚信这只手“不属于他”。入院时，他拒绝进行再植手术，并被发现没有精神疾病。他被诊断为身体完整性认同障碍（BIID），并被宣布有能力做出自己的医疗决定。随后进行了修正性截肢。
结论
BIID 是一个具有挑战性的诊断，治疗创伤性损伤的医生应该对此有所了解。许多伦理学家支持选择性截肢作为一种确定性治疗方法，因为这可以降低潜在伤害，而且 BIID 不会对药物治疗等保守治疗方法产生反应。
Zotero 插件