A Tragic Scenario of Munchhausen Syndrome (Child Abuse)

Introduction:Factitious disorder imposed on self, also known as Munchausen syndrome, is a factitious disorder wherein those affected feign disease, illness, or psychological trauma to draw attention, sympathy, or reassurance to themselves. Munchausen syndrome fits within the subclass offactitious disorder with predominantly physical signs and symptoms, but patients also have a history of recurrent hospitalization.Case Report: A 7-year-old girl was brought to or hospital due to intractable vomiting. She was operated due to malrotation and adhesion release for 5 times in another pediatric surgery center. After contrast study we found some degrees of malrotation, at the time of operation we found only some adhesion bands without significant obstruction. The patients had intractable vomiting; therefor we inserted a jugular CV- line forTPN. Some days later the girl had intractable bloody vomiting and decreased Hgb repeatedly. Therefor we had to infuse whole blood regularly. Unfortunately, after two months of hospitalization, we understood her mother took blood from IVline and mixed it with vomited materials after gag induced reflex. Discussion:Researchers believe both biological and psychological factors play a role in the development of this disorder, however the exact cause of factitious disorder is not known. Risk factors of factitious disorder include childhood traumas, growing up with parents/caretakers with emotional problems, a serious illness as a child, and low self-esteem.This syndrome is named as hospital addiction, polysurgical addiction or professional patient syndrome also. A similar behavior called factitious disorder imposed on another has been documented in the parent or guardian of a child. Furthermore, a disease may actually be initiated in the child by the parent or guardian. This condition is considered distinct from Munchausen syndrome. There is growingconsensus in the pediatric community that this disorder should be renamed medical abuse to highlight the harm caused by the deception and to make it less likely that a perpetrator can use a psychiatric defense when harm is done.Conclusion:It is important to think about this syndrome as a differential diagnosis of a patient with multiple hospitalizations due to similar or different presentations of disease, especially when we have no results for these recurrent presentations.