Today in Weird patientthe case of a man who swallowed more than a thousand coins!
In 2017, a 51-year-old Japanese man arrives at the hospital closest to his home. The reasons for his visit are unspecific and do not bode well for the disease that is really eating away at him. Depressed for 30 years, he takes no medication, but is more tired than usual and has no appetite. The doctors carry out a battery of preliminary tests which reveal nothing in particular: his blood pressure is normal as well as his heart rate. But his blood tests are more worrying. The patient is anemic, lacks iron and has excessively high white blood cell counts. However, there are no signs of a more serious problem such as liver or kidney failure. On palpation, a doctor notices that her abdomen is hard and tense on the right side. Chest CT confirms there’s a problem. Perfectly round shapes located along his esophagus shine in the images. An impressive amount of these rounds are piled up to the left of the stomach, completely deforming it.
Doctors are faced with a strange case of a person who ate… coins so much that they perforated the wall of his intestinal tract. He is transferred to a hospital in Tokyo to remove the parts from his body. There, the surgeons recovered 1,894 Japanese coins, of various denominations, for a total weight of eight kilos. Doctors were unable to find out how long the coins had been in the patient’s digestive system, but the attack was likely recent since he did not have zinc or copper poisoning, the main components of the coins.
Eating objects, a confusing disorder
Pica is a psychological disorder in which people eat objects and materials that have no nutritional value and can endanger their lives. Intestinal obstruction, poisoning or infection are possible complications. While cases of pica are rare, the incidence of this confusing behavior is higher in people with schizophrenia, or even in pregnant women. Our Japanese patient was diagnosed with schizophrenia following his operation and treated in a psychiatric hospital.
Among all the existing forms of pica, the one that consists of swallowing coins is quite rare. The doctors who described the case presented above in 2017 identified seven cases between 1975 and 2017, three of which were fatal. Since, another case was described in 2021, in a 33-year-old schizophrenic man who ate coins, but also nails, pieces of glass or pebbles. The origins of this behavior are still debated. Some think it is a symptom of obsessive-compulsive disorder, often associated with schizophrenia; others, a side effect of antipsychotic drugs.