The story of pebble eater !

Clinical scenario :
A 20 yr old student  presented with history of recurrent abdominal pain of 2 years duration
Every time he would  be treated symptomatically in a local hospital .The abdominal examination would reveal no abnormality , every time he was admitted to the hospital.

He never had features of small bowel obstruction

The clinical examination was normal. Although not indicated the  resident on duty ordered an X ray abdomen  as shown Fig 1 showing multiple radio opaque shadows  in the abdomen .there were  no air fluid level ruling out features of obstruction

Fig 1 X Ray Abdomen showing multiple radio opaque shadows

Fig 2 Endoscopy showed multiple stones in stomach On repeated questioning   the patient  admitted to ingestion of  beach side stones  Family  never knew it . Initially, he denied any precipitating factor but later  he stated that  whenever he underwent some academic difficulties leading to a hard discussion in the family. He could not tolerate it, then he would go  lonely and would swallow  few stones. The pebble eater never intended to kill himself . He intended to release his stress and to seek family attention.

        What happened could  be explained as an impulsive act ! Exclaimed our psychiatrist . Patient was given psychotherapy and father was explained the phenomenon , since then  the pebble eater   never attended the hospital with pain abdomen .

Multiple visits to a physician , the mystery unraveled by a psychiatrist finally : The story of pebble eater :