Lithophagia in a 4-Year-Old Child

Lithophagia is a form of pica syndrome, characterized by the ingestion of stones. It is an eating behavior disorder primarily observed in children and often associated with neurodevelopmental disorders or nutritional deficiencies. This condition may lead to severe complications such as intestinal obstruction, gastrointestinal perforation, or even acute bowel obstruction requiring prompt and appropriate medical management. We report the case of a 4-year-old girl who was initially hospitalized for hydrocarbon poisoning. Upon admission, the patient presented with a fever of 39°C, acute respiratory distress with severe tachypnea at 45 breaths per minute, and signs of respiratory struggle. Chest radiography revealed an alveolar consolidation in the left lower lobe, suggestive of aspiration pneumonia. In addition, the patient complained of severe abdominal pain, prompting an abdominal ultrasound, which returned without abnormalities. The clinical course was marked by worsening of the abdominal symptoms, with cessation of stool and gas passage, leading to the performance of a plain abdominal X-ray. The imaging revealed multiple radio-opaque objects scattered throughout the intestinal tract, highly suggestive of foreign body ingestion. Symptomatic treatment was initiated, including close clinical monitoring and stool surveillance, which led to the passage of stones in the feces, thereby confirming the diagnosis of lithophagia. Furthermore, the child showed no signs of anemia, and her serum ferritin levels were within the normal range. Zinc level testing was indicated.