BehindTheMedspeak: Pica

Each week, the New England Journal of Medicine features an image which it challenges its readers to diagnose.

The answer appears in the next weekly issue, along with a new mystery image.

The one above appeared on January 1 of this year.

It seems a 62-year-old man appeared at a French hospital with a swollen belly, complaining of abdominal pain.

After the x-ray above was taken, he was rushed to surgery, where doctors found the source of his problem: $650 worth of change, weighing 12 pounds.

There were French, British, and euro coins.

The man had a condition known as pica (Latin for magpie, a bird known for eating practically anything).

People with pica have been known to eat ashes, hair, laundry detergent, chalk, soil, lime, charcoal, dust, paint chips, burnt matches, ice, and soap, among other things.

Metal objects like coins are sometimes favored.

In the U.S., adult pica persists among some African-American women, pregnant women, and women in the South.

Some studies estimate the prevalence to be 9%-25% among women of child-bearing age.

Though some specialists think pica may be linked to mineral deficiencies, others believe it is a cultural practice.

It can also be a feature of mental illness.

In the French patient reported above, a 15-year history of chronic psychosis was present.

[via Ranit Mishori and the Washington Post]