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Geophagy in Children: A Rare Cause of Bowel Obstruction

Ayoub Elhajjami, Dounia Basraoui, Hicham Jalal and Mohamed Oulad Saiad

Geophagy is an eating disorder defined by an irresistible urge to ingest soil or clay. This cosmopolitan practice has always challenged the medical world. The aim of our work is to discuss a rare case of intestinal obstruction due to geophagy and to illustrate the role of imaging in the diagnosis and management of this condition.

A 5-year-old child presented in the emergency unit complaining from painful abdomen and bile stained vomiting during 24 h. Clinical examination revealed fever, a distended and tender abdomen, and rectal examination feels hard stools. Upright abdominal radiograph showed a significant gastric and intestinal distension with a granite-like content covering the entire digestive tract with some air-fluid levels, confirming the diagnosis of bowel obstruction. In exploratory laparotomy intraperitoneal cavity and intestinal lumen were full of soil and sludge associated to a sigmoid perforation.

Geophagy is a rare but serious cause of bowel obstruction, awareness of this problem is essential for early diagnosis and effective management. The diagnosis is based on clinical and abdominal plain X-ray.