Repeated Enterocutaneous Fistula in a Munchausen Syndrome Patient

We describe a case of repeated enterocutaneous fistula in Munchausen syndrome. A 53-year-old Japanese male was admitted to our hospital for the treatment of a high-flow enterocutaneous fistula. Surgery was performed two times, but the fistula recurred each time. Chopsticks with blood on them were coincidentally detected in the trash in the patient ’s room. It was revealed that the enterocutaneous fistula was caused by self-mutilation. A psychiatrist was consulted, and the patient was diagnosed with Munchausen syndrome. The psychiatrist initiated treatment and the patient admitted the self-harm. His prolonged wound site was closed and he was able to be discharged. There has been no recurrence of the self-harm as of this writing, 3 years later. The treatment of Munchausen syndrome is difficult and early detection is important.Case Rep Gastroenterol 2019;13:173 –177
Source: Case Reports in Gastroenterology - Category: Gastroenterology Source Type: research