A rare complication of pica: Stone aspiration with severe respiratory distress

• Published in: Nigerian journal of clinical practice Vol. 24; no. 2; pp. 295 - 298
• Main Authors: Ekinci, F, Yildizdas, D, Horoz, O, Kilic, S, Gokay, N
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01-02-2021; Medknow Publications and Media Pvt. Ltd
• Subjects: Bronchi - diagnostic imaging; Bronchoscopy; Case studies; Causes of; Child; Child, Preschool; Complications and side effects; Diagnosis; Foreign bodies (Medical care); Foreign Bodies - complications; Foreign Bodies - diagnostic imaging; Foreign Bodies - surgery; Humans; Infant; Iron deficiency anemia; Pediatric research; Pica (Pathology); Pica - complications; Respiratory Distress Syndrome; Retrospective Studies; Turkey; pica; stone aspiration; Foreign body aspiration; iron deficiency anemia
• ISSN: 1119-3077
• DOI: 10.4103/njcp.njcp_195_20

Tracheobronchial foreign body aspiration (FBA), a common pediatric presentation to emergency departments, is still a public healthcare problem affecting children all over the world. There are several types of foreign bodies reported from different parts of the world, including both organic or nonorganic substances. Pica, another interesting clinical entity, is characterized by persistent eating of nonnutritive substances, which is inappropriate for the maturation stage of the individual. A 3-year-old pediatric patient was admitted to our emergency department with a 3-day history of coughing and new onset respiratory distress. A chest X-ray was performed and it showed a suspicious radiopaque foreign body in the localization of left bronchi. Urgent rigid bronchoscopy was performed. The foreign body in the left main bronchi was, surprisingly, a 0.5-1 cm diameter, irregularly shaped stone particle. The laboratory evaluations and patient history revealed the diagnosis of severe iron deficiency anemia and accompanying pica. Stone aspiration, as an FBA, is a rare but potentially life-threatening complication of pica. Iron deficiency anemia accompanied by pica should be diagnosed and treated in the early stage of the disease because of their complications. According to our knowledge and literature search, this is the first case of stone aspiration as a complication of severe iron deficiency anemia and pica.