A Pediatric Case of Factitious Disorder (Munchausen’s Syndrome) Requiring a Differential Diagnosis From Upper Gastrointestinal Bleeding

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  • Hijikata Kohei
    Department of Pediatric Surgery, Teikyo University School of Medicine
  • Hosoda Toshifumi
    Department of Pediatric Surgery, Teikyo University School of Medicine
  • Ishioka Shigeki
    Department of Pediatric Surgery, Teikyo University School of Medicine

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Other Title
  • 吐血を訴えた作為症/虚偽性障害（いわゆるミュンヒハウゼン症候群）の1例
  • トケツ オ ウッタエタ サクイショウ/キョギセイ ショウガイ(イワユル ミュンヒハウゼン ショウコウグン)ノ 1レイ

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<p>Factitious disorder, a mental disease in which patients act as if they have physical symptoms of a disease, is rare in children. We report a pediatric case of factitious disorder requiring a differential diagnosis from upper gastrointestinal bleeding. A 13-year-old girl was referred to our hospital with black stool. Examinations by abdominal CT, upper gastrointestinal endoscopy and Meckel’s diverticulum scintigraphy showed normal findings. During outpatient follow-up, the patient complained of hematemesis and was admitted to our hospital for further examination. Upper gastrointestinal endoscopy was performed again, and again it showed no abnormal findings. During admission, the hospital staff saw that the patient drew her own blood intravenously with a syringe. Then, the patient complained of hematemesis. From this observation, the patient was diagnosed as having factitious disorder. We need to consider factitious disorder as a differential diagnosis in unexplained cases despite appropriate examinations.</p>

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