We also wish to stress that the radiologist's role often does not end with writing the radiology report, but it can extend to making an etiological diagnosis by obtaining an appropriate history and making fundamental observations about the pathology seen in radiological images. Choose articles related to Zellweger Syndrome Radiology, search nearby. Preventive medicine and counseling for removal of the patient from the stressor environment, altering the lifestyle, education, and medical treatment of the underlying psychiatric disorder are of prime importance after providing symptomatic treatment.
A large quantity or large size may cause intestinal obstruction requiring surgical intervention. The material is nontoxic and indigestible. Diagnosis is made clinically with pain with compression of the patella and moderate lateral facet tenderness and sunrise knee radiographs will often show patellar tilt in the lateral. Treatment of pencil eraser consumption is laxative therapy for evacuation of the substance. Lateral patellar compression syndrome is the improper tracking of the patella in the trochlear groove generally caused by a tight lateral retinaculum. In our patient, evaluation of suspected substance and its confirmation helped in alleviating the symptoms and avoiding aggressive management. Since pencil erasers are readily available to children, it is important for pediatricians and radiologists to be aware of the symptoms, clinical, and radiological signs of pencil eraser consumption. Consumption of a large quantity may cause intestinal obstruction requiring surgical intervention. Nevertheless, the erasers can cause delayed transit and sluggish peristalsis in the intestine, presenting with constipation. Hence, the digestive system and the metabolic pool are not exposed to the toxicity of sulfur. The human digestive mechanism is unable to breakdown the erasers into their individual ingredients. Sulfur is added to the eraser to achieve elasticity. Pencil erasers have not been reported as being a cause for Pica.Įrasers are highly radio-opaque due to the sulfur content. Metallic substances and glass particles are known radio-opaque substances observed in Pica. Chronic constipation is one of the most common causes of recurrent abdominal pain. A diagnostic radiologist should be aware of these unusual conditions so as to provide timely diagnosis and aid in the management of these conditions.Ī plain upright radiograph is by far the most common requested examination in a child presenting with pain in abdomen. Prompt attention and specialized help would prevent complications and further deterioration of the condition. Pica can be an indicator of the underlying psychosocial stress or a psychiatric disorder. Detailed psychosocial history, clinical evaluation, and corresponding investigations are required to arrive at the diagnosis. The diagnosis and management of Pica needs a multimodality approach with active involvement of pediatrician, psychologist–psychiatrist, radiologist, and parents/family members. This phenomenon triggers a cascade of events at a cellular level, that if the circulation is not restored in time, will lead to cell death. There can be nutritional deprivation due to failure to thrive. Pathology Acute interruption of blood flow through the AICA which leads to deprivation of oxygen and glucose in the vascular territory supplied. Commonly reported are cases with lead poisoning when children have consumed wall paint, intestinal obstruction due to formation of bezoars, gastroenteritis, parasitic infestations, internal bleeding, and perforation due to sharp objects. Substances that have been commonly consumed in Pica include soil or mud (geophagia), feces (coprophagia), hair (trichophagia), glass (hyalophagia), wall paint, wooden materials (xylophagia), and so on.Ĭomplications of Pica depend on the substance consumed. In certain sections of the society, it may be associated with cultural practices such as consumption of clay in African American women. Pica has been associated with pregnancy, obsessive compulsive disorder, schizophrenia, emotional stressors, and autism. The intracranial occlusive disease without V1 lesion was usually correlated with small cerebellar lesions in PICA and superior cerebellar artery (SCA).
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