Munchausen'S syndrome by proxy: a case report

Area of Science:

• Pediatric Gastroenterology
• Child Psychology

Background:

• Recurrent rectal bleeding in children can mimic serious gastrointestinal or hematologic conditions.
• Extensive investigations are often performed to rule out organic causes of rectal bleeding.

Purpose of the Study:

• To highlight a rare case of factitious disorder presenting as recurrent rectal bleeding in a pediatric patient.
• To emphasize the importance of psychiatric evaluation in unexplained pediatric conditions.

Main Methods:

• Case report detailing a two-year-old male with a two-month history of rectal bleeding.
• Review of prior extensive investigations for gastrointestinal and bleeding disorders.
• Psychiatric interview with the mother revealing self-induced rectal bleeding.

Main Results:

• All organic gastrointestinal and bleeding disorders were ruled out through comprehensive testing.
• The mother confessed to inducing rectal bleeding by injuring the child's rectal mucosa.

Conclusions:

• Factitious disorder imposed on another (previously called Munchausen by proxy) should be considered in cases of unexplained recurrent rectal bleeding.
• Early psychiatric assessment is crucial for accurate diagnosis and management of such pediatric cases.