A Review of the Forensic Implications of Pica
Corresponding Author
Roger W. Byard M.B.B.S., M.D.
The University of Adelaide Medical School, Frome Road, Adelaide, SA, 5005 Australia
Forensic Science SA, 21 Divett Place, Adelaide, SA, 5000 Australia
Additional information and reprint requests:
Prof Roger W. Byard, M.B.B.S., M.D.
Discipline of Anatomy and Pathology
Level 3 Medical School North Building
The University of Adelaide
Frome Road
Adelaide, SA 5005
Australia
E-mail: [email protected]
Search for more papers by this authorCorresponding Author
Roger W. Byard M.B.B.S., M.D.
The University of Adelaide Medical School, Frome Road, Adelaide, SA, 5005 Australia
Forensic Science SA, 21 Divett Place, Adelaide, SA, 5000 Australia
Additional information and reprint requests:
Prof Roger W. Byard, M.B.B.S., M.D.
Discipline of Anatomy and Pathology
Level 3 Medical School North Building
The University of Adelaide
Frome Road
Adelaide, SA 5005
Australia
E-mail: [email protected]
Search for more papers by this authorAbstract
Pica is characterized by the persistent eating of non-nutritive substances over some time that is inappropriate for the maturation stage of the individual and is not culturally sanctioned. A 9-year-old boy with Goldenhar syndrome, significant developmental delay and pica, collapsed and died after a short history of diarrhea and vomiting. Death was due to a sigmoid volvulus resulting from filling of the distal colon with feces containing dirt, stones, and rice with evidence of ischemic intestinal necrosis. Lethal complications of pica include intestinal obstruction and perforation with peritonitis and generalized sepsis. Other findings at autopsy may include airway obstruction, heavy metal poisoning, and parasitic infestation. Presenting symptoms and signs of such complications may be subtle or masked given the nature of underlying conditions, and so careful evaluation of the medical histories of individuals with pica may be necessary to provide pertinent details of associated medical and psychiatric conditions.
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