Official websites use. Share sensitive information only on official, secure websites. Corresponding author: Theodore A. The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. Such consultations require the integration of medical and psychiatric knowledge. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss the diagnosis and management of conditions confronted.
These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry. Drs Unruh and Nejad and Mr Stern report no financial or other affiliations relevant to the subject of this article. Have you ever had to evaluate and manage a patient with polyembolokoilamania inserting a foreign body into 1 body orifice or more?
Have you wondered why he or she did it and been surprised by your reactions to their behavior? If you have, then the following case vignette and discussion should prove useful with your approach to and management of patients who insert foreign bodies into themselves. Although insertion of foreign bodies into bodily orifices is not uncommon, relatively little has been written about its predisposing factors, its complications, or its management.
Care required is often collaborative, involving primary care physicians who oversee the patient's care , surgeons who assess the need for surgical removal or management of its complications, eg, perforated viscera , infectious disease specialists re: infections , and psychiatrists mental status and psychiatric assessment of reasons for foreign body insertion, eg, psychosis, self-injury, erotic pleasure, malingering, factitious illness.
In addition, such individuals and their behaviors evoke intense emotional reactions eg, disgust, anger, embarrassment, fear that threaten to interfere with medical care eg, via avoidance, a lack of compassion or empathy, hostility. Psychiatric consultation may facilitate a greater understanding of the patient and his or her dilemma so that timely treatment and effective care can be initiated.
