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Medeiros Nunes M, Maia CR, de Andrade Santos PR, de Lisboa Lopes Costa A, de Moura SAB, de Andrade Santos PP. Self-mutilation: a systematic review. Forensic Sci Med Pathol 2025; 21:430-442. [PMID: 38613622 DOI: 10.1007/s12024-024-00809-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2024] [Indexed: 04/15/2024]
Abstract
Self-mutilation lesions can represent a clinical diagnosis challenge for healthcare professionals, as patients do not admit to self-mutilation. This leads to failed diagnoses due to the similarity of this condition to other diseases. Searches on the subject were carried out at the PubMed, Periódicos Capes, Scopus, Science Direct and WoS databases, according to the following inclusion criteria: articles in English, Portuguese or Spanish, published from 2018 to June 2023, encompassing case reports, case series and literature reviews. Men are slight more affected by self-mutilation injuries, also presenting the most serious lesions. Self-mutilation injuries are reported globally, mostly in the Asian and American continents. Clinical presentations are varied, but morphology is, in most cases, associated to the form/instrument used for self-mutilation. Greater evidence of diagnosed mental disorders in women and underreporting of these cases in men due to low demands for specialized treatment are noted. A higher prevalence of self-mutilation lesions was verified for men, affecting a wide age range, with the highest number of cases in the USA. The most affected body areas are arms and external genitalia, mostly due to knife use. An association between self-mutilation injuries and mental disorders is clear, with most cases being previously undiagnosed.
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Affiliation(s)
- Matheus Medeiros Nunes
- Postgraduate Program in Structural and Functional Biology, Department of Morphology, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Caio Rodrigues Maia
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | | | - Antônio de Lisboa Lopes Costa
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Sérgio Adriane Bezerra de Moura
- Postgraduate Program in Structural and Functional Biology, Department of Morphology, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Pedro Paulo de Andrade Santos
- Postgraduate Program in Structural and Functional Biology, Department of Morphology, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil.
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil.
- Centro de Biociências, Departamento de Morfologia, Universidade Federal do Rio Grande do Norte (UFRN), Campus Universitário, Lagoa Nova, CEP 59072-970, Natal, RN, Brasil.
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Negrete JR, Carrillo MD, Molina GA, Ayala O AV, Flores D, Castillo D. Do not open wide; accidentally swallowed dental mold causing bowel obstruction. A case report. J Surg Case Rep 2022; 2022:rjac384. [PMID: 36118991 PMCID: PMC9473515 DOI: 10.1093/jscr/rjac384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/03/2022] [Indexed: 11/23/2022] Open
Abstract
Foreign body ingestion is a common condition in daily practice; fortunately, most cases do not require endoscopic or surgical treatment, as most foreign bodies pass through the intestine without injuring it. Although mainly seen in children, adults can also be affected, especially in accidental situations and suicide attempts. Therefore, the clinical history and the environment in which the event occurred are essential for a rapid diagnosis. This can be even more challenging as most adult patients are rarely aware of ingestion. Therefore, a high index of suspicion is necessary. Therapy will depend on the foreign body’s size, shape and material; treatment should not be delayed if complications are detected. We present a case of a 34-year-old man who accidentally swallowed the mold of his teeth while undergoing a dental procedure. Subsequently, he presented with an intestinal obstruction that required surgery. Fortunately, he made a full recovery.
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Affiliation(s)
- Jose R Negrete
- Department of General Surgery Hospital Vozandes , AXXIS Hospital & UIDE, Quito , Ecuador
| | | | - Gabriel A Molina
- Department of General Surgery Hospital Metropolitano & Universidad San Francisco de Quito (USFQ) , Quito , Ecuador
| | - Andres V Ayala O
- Department of General Surgery AXXIS Hospital & UIDE , Quito , Ecuador
| | | | - Daniel Castillo
- Department of Internal Medicine AXXIS Hospital , Quito , Ecuador
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Espin DS, Tufiño JF, Cevallos JM, Zumárraga F, Orozco VE, Proaño EJ, Molina GA. A needle in the colon, the risk of ingested foreign objects: a case report. J Surg Case Rep 2021; 2021:rjab455. [PMID: 34703574 PMCID: PMC8542396 DOI: 10.1093/jscr/rjab455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 09/20/2021] [Indexed: 12/30/2022] Open
Abstract
Ingestion of foreign bodies is often found in clinical practice; however, intestinal perforation due to ingestion of foreign bodies is rare. Sharp and metallic objects are usually the ones that cause most complications. Preoperative diagnosis is difficult since the clinical presentation is vague and nonspecific presentation can simulate many abdominal pathologies. Patients are rarely aware of foreign body ingestion, and a high index of suspicion is required to make a timely diagnosis. In addition, treatment demands prompt surgery to avoid dangerous complications. We present the case of a 19-year-old tailor; he inadvertently swallowed a needle and presented to the emergency department with a colonic perforation. Surgery was required, and he recovered completely.
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Affiliation(s)
- Darwin S Espin
- Department of General Surgery, Hospital San Francisco, IESS, Quito, Ecuador
| | - Jorge F Tufiño
- Department of General Surgery, Hospital San Francisco, IESS, Quito, Ecuador
| | - Jaime M Cevallos
- Department of General Surgery, Hospital San Francisco, IESS, Quito, Ecuador
| | | | - Vanessa E Orozco
- PGY3 Pontificia Universidad Catolica del Ecuador, Quito, Ecuador
| | | | - Gabriel A Molina
- Department of General Surgery at Hospital Metropolitano & Universidad San Francisco (USFQ), Quito, Ecuador
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