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Munchausen's syndrome presenting as rectal foreign body insertion: a case report
Shakeeb A Khan1, Christine A Davey, Shamsul A Khan
1Department of Liaison Psychiatry, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK. peter.trigwell@leedsth.nhs.uk.
Cases Journal
|October 18, 2008
Summary
Munchausen's syndrome can manifest as rectal foreign body insertion, a presentation often overlooked. Clinicians should consider factitious disorder, not just sexual motives, for accurate diagnosis and treatment.
Area of Science:
- Medicine
- Psychiatry
- Gastroenterology
Background:
- Rectal foreign body insertion is a known clinical presentation.
- Motivations for insertion are typically assumed to be sexual gratification.
- Insertion for reasons other than sexual gratification is rarely considered in literature.
Purpose of the Study:
- To highlight Munchausen's syndrome as a potential cause of rectal foreign body insertion.
- To emphasize the importance of considering factitious disorder in diagnosis.
- To guide clinicians in evaluating patients with rectal foreign bodies.
Main Methods:
- Case report of a 30-year-old male presenting with rectal foreign body insertion.
- Clinical examination and diagnostic assessment.
- Review of current knowledge on Munchausen's syndrome and rectal foreign bodies.
Main Results:
- Diagnosis of Munchausen's syndrome was established.
- The case illustrates how assumptions can lead to missed diagnoses.
- Appropriate treatment requires accurate identification of the underlying cause.
Conclusions:
- Clinicians must consider Munchausen's syndrome (factitious disorder) in rectal foreign body cases.
- Avoid assuming sexual gratification as the sole motivation.
- Early psychiatric consultation is recommended for effective management.
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