Mania operativa: an uncommon, unrecognized cause of limb amputation

Mania operativa is an obsession with pain and disability and the seeking of relief from this pain by repeated surgical procedures. The authors report eight patients in whom a minor injury was followed by multiple operations, culminating in amputation of the upper or lower limb, at increasingly higher levels, in an unsuccessful attempt to relieve the patient's pain. They believe these patients had mania operativa. There are many varieties of psychogenic pain, which present the surgeon with a problem in both diagnosis and management. The authors discuss identifiable factors in the patient, the surgeon and society. By calling attention to this condition, they hope to avoid unnecessary multiple surgical procedures on such patients.