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Related Concept Videos

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Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
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In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
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Related Experiment Video

Updated: Oct 23, 2025

A Mouse Model of Intestinal Partial Obstruction
07:33

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Lethal small bowel obstruction due to pica.

Johannes Rødbro Busch1, Lars Löchte1, Anna-Sofia Lindh1

  • 1Section of Forensic Pathology, Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark.

Journal of Forensic Sciences
|August 25, 2021
PubMed
Summary

Patients with cognitive deficiencies may exhibit pica-like behavior, leading to small bowel obstruction. Early diagnosis through liberal radiological investigation is crucial for this vulnerable population.

Keywords:
autopsycognitive deficiencyforeign bodyforensic pathologylanguage deficiencypicasmall bowel obstruction

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Area of Science:

  • Forensic Pathology
  • Gastroenterology
  • Internal Medicine

Background:

  • Pica-like behavior affects up to 25% of institutionalized patients with cognitive deficiencies.
  • Small bowel obstruction (SBO) has an estimated annual incidence of 2% in this population.
  • Cognitive and language deficits can complicate diagnosis and history-taking.

Observation:

  • A case report details a forensic autopsy of a 41-year-old woman with a missed diagnosis of SBO.
  • The patient ingested a foreign body, leading to fatal obstruction.
  • Gastrointestinal symptoms in patients with cognitive impairment warrant high suspicion.

Findings:

  • Missed diagnosis of SBO due to foreign body ingestion can be fatal.
  • A high index of suspicion and liberal use of radiological imaging are essential.
  • Obtaining medical history from caregivers or close relations is vital.

Implications:

  • Highlights the critical need for vigilance in managing gastrointestinal symptoms in patients with cognitive or language impairments.
  • Emphasizes the importance of a low threshold for diagnostic imaging to prevent fatal outcomes.
  • Underscores the necessity of a multidisciplinary approach involving caregivers for accurate patient assessment.