Case contributed by Ashesh Ishwarlal Ranchod
Diagnosis certain


The patient presents with gastroesophageal reflux, and non-specific abdominal pain, for further clinical and imaging workup.

Patient Data

Age: 40 years
Gender: Female

Dense feacal matter is demonstrated within the large bowel, especially the descending colon. There is no bowel obstruction and no free intraperitoneal air. Parapelvic metallic tubal ligation clips are present.The abdominal X-rays are otherwise unremarkable.

Case Discussion

Abdominal X-rays identified dense fecal matter. A search on PACS failed to reveal any prior imaging and possible oral contrast media administration. The patient's medication was also checked, and excluded drugs that may account for the findings, specifically thyroid and cardiac medications.

On further questioning, the patient revealed eating soil. This case is an example of geophagy and represents the intentional consumption of soil, earth or clay. Geophagy is a known form of pica.

Geophagy is often present in patients with iron deficiency anemia. This patient's hemoglobin at presentation is 8.4g/dl (normal range 12.4- 16.7g/dl). She is being worked up for iron deficiency anemia and underwent a blood transfusion.

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