Case report
Munchausen syndrome in the emergency department mostly difficult, sometimes easy to diagnose: a case report and review of the literature
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* Corresponding author: Rinaldo Lauwers rinaldo.lauwers@uzbrussel.be
1 Emergency Department UZ Brussel, Brussels, Belgium
2 Department of Surgery UZ Brussel, Brussels, Belgium
3 Department of Psychiatry UZ Brussel, Brussels, Belgium
World Journal of Emergency Surgery 2009, 4:38 doi:10.1186/1749-7922-4-38
Published: 12 November 2009Abstract
Munchausen syndrome is a rare psychiatric disorder in which patients inflict on themselves an illness or injury for the primary purpose of assuming the sick role. Because these patients can present with many different complaints and clinical symptoms, diagnosis is often made at a later stage of hospitalisation. In contrast we report a case of a 40-year old woman very easy to diagnose with Munchausen syndrome.
This trained nurse presented at our emergency department (ED) complaining of abdominal pain. Interviewed by the medical trainee, she immediately confessed having put a knitting needle into her urethra four days earlier. She was not able to remove it anymore because it was beyond her reach. Abdominal X-ray confirmed the presence of the needle and a median laparotomy was performed to remove it. The diagnosis of Munchausen syndrome seemed immediately obvious in this case.