Acuphagia as a cause of gastric bezoar causing gastric outlet obstruction

Acuphagia, the compulsive ingestion of sharp objects is a rare form of Pica. A 25 years old female presented in Outpatient Department with complaints of persistent pain in epigastrium and melena for one month. Initially treated for gastritis, she failed to respond to the therapy. Her upper Gastrointestinal (GI) endoscopy was planned which showed a mass of needles and blades in the fundus of stomach. An attempt was made for endoscopic removal but this was not possible without damaging the esophagus. On inquiring again she gave a history of ingestion of metallic pins and blades after a fight with her husband. She was admitted with a diagnosis of acuphagia. She underwent a formal laparotomy with anterior gastrostomy. A total of 40 shaving blades and 508 sewing machine needles were recovered. Her postoperative recovery was uneventful. Upon discharged, she was referred to Department of Psychiatry for evaluation and treatment.