CASE REPORT A 4-year-old girl presented with history of not passing stools for 7 days. Patient had stable vitals and abdominal distension with tympanic note on percussion. X-ray erect abdomen showed a large radio-opaque shadow in the pelvis with multiple small radiodense shadows scattered over the abdomen (Figure 1). Computed tomography scan of the abdomen showed large hyperdense intraluminal lesion involving the rectum and sigmoid colon. The density of this lesion was >900 Hounsfield units (Figure 2). The patient and her parents denied history of any oral or rectal administration iodinated contrast medium. Patient was examined under sedation, and multiple firm impacted indentable stools were felt and removed. The remainder of the stools were cleared with enema. The stools showed large amounts of clay and sand particles confirming diagnosis of geophagia (Figure 3). A detailed history later revealed no such episodes in past; however, the parents reported geophagia since over 1.5 years. Patient was discharged on laxative and is asymptomatic since with no residual radio-opaque shadows on X-ray (Figure 1).Figure 1.: (A) X-ray erect abdomen showing a large radio-opaque shadow in the pelvis with multiple small radiodense shadows scattered over the abdomen. (B) Post-treatment X-ray erect abdomen showing resolution of all radiodensities.Figure 2.: Computed tomography scan image of the abdomen showing large hyperdense intraluminal lesion involving the rectum and sigmoid colon.Figure 3.: Stools containing large amount of clay and sand particles.DISCLOSURES Author contributions: All authors participated in data collection, analysis, final drafting, and proof-reading of the final manuscript. V. Chaudhari is the article guarantor. Financial disclosure: None to report. Informed consent was obtained for this case report.
Chaudhari et al. (Sun,) studied this question.