SHM Converge Scientific Abstract ePoster Gallery-An Unexpected Cause of Weight Loss in a Thirteen-Year-Old Girl

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A previously healthy 13-year-old girl presented with 8 months of abdominal discomfort, decreased intake, 11 kg weight loss, hyponatremia, iron deficiency anemia, and elevated inflammatory markers. Initial findings, including bowel wall thickening on ultrasound, raised concern for inflammatory bowel disease, celiac disease, eosinophilic enteritis, or malignancy.  <br /><br />Her symptoms worsened, prompting CT imaging, which showed small bowel obstruction caused by numerous coiled dense linear foreign bodies. Although she denied ingesting non-food items, exploratory laparotomy revealed volvulus of the ileum and a contained small bowel perforation due to innumerable elastic hair ties and headbands in the stomach and small intestine. She underwent segmental ileal resection, re-anastomosis, gastrostomy, and foreign body removal.  <br /><br />The case highlights pica as an important but often missed cause of chronic weight loss and nonspecific gastrointestinal symptoms in children and adolescents, especially when iron deficiency anemia or psychosocial risk factors are present. Imaging can be critical in revealing retained foreign bodies before more invasive diagnostic procedures are pursued. After surgery, her hyponatremia resolved with nutrition and hydration, and she was discharged on iron supplementation and psychiatric follow-up for pica. Six months later, she was regaining weight.

Asset Subtitle

Danni Liang

Meta Tag

Author List Danni Liang, Elizabeth E. Dong, Gabriel Tse, Neha S. Joshi

Category Clinical Vignettes

Concept Pica

Concept Foreign Body

Concept Bowel Obstruction

Concept Bowel Perforation

Concept Weight Loss

Distinguished Non-Finalist

Presenter Organization Stanford

Presenting Author Danni Liang

Track Pediatric

Keywords

pica

abdominal pain

weight loss

iron deficiency anemia

small bowel obstruction

foreign body ingestion

ileal volvulus

bowel perforation

adolescent

gastrointestinal imaging

Pica

Foreign Body

Bowel Obstruction

Bowel Perforation

Weight Loss