An Impacted Foreign Body (A Betel Nut) in Umbilicus with Umbilical Hernia

A CASE REPORT AN IMPACTED FOREIGN BODY (A BETEL NUT) IN UMBILICUS WITH UMBILICAL HERNIA INTRODUCTION Polyembolokoilamania1 (inserting a foreign body into 1 body orifice or more) is a psychiatric disorder. Here patient had the habit of reducing the umbilical hernia with a betel nut. On one such attempt he failed to do so and the betel nut got stuck in the umbilicus. CASE REPORTA 56 year old male Hindu patient of low socio-economic class presented with the chief complaint of painful swelling over the umbilicus with serous discharge since 4 days with foreign body in situ since 8 days. Patient used to reduce umbilical hernia with the help of a betel nut. Patient had inserted it before 8 days but failed to remove it and pain and swelling increased. Patient had no associated complaints of vomiting, constipation, distension, fever. MANAGEMENTA small transverse incision was made and betel nut was removed under G. A. with Omphalectomy done and Umbilical hernia defect repaired and meshplasty done with prolene mesh. Post operative period was uneventful. DISCUSSION Case reports of insertion /impaction of foreign body are associated with self injurious behaviour characteristics of bipolar disorder. However some cases have been thought secondary to Munchausen syndrome or secondary gain. In this type of psychiatric illness mostly foreign body is inserted into anus, urethra or vagina.