GASTRIC phytobezoars are uncommon in children, and associated perforation is a rare abdominal catastrophe. The additional feature of clostridial contamination complicated the case reported here.
Report of a Case
A 31-month-old male hemophiliac (factor 8) was admitted to the San Francisco General Hospital on March 31, 1967, for acute oral hemorrhage sustained while eating hard candy. When this child had last been hospitalized for a similar episode of oral hemorrhage (March 21), his packed cell volume (PCV) had been 20%.Physical examination revealed oozing from a 4-mm laceration of the hard palate. Blood pressure was 100/50 mm Hg; pulse rate, 124 beats per minute; and PCV, 25.5%.Hemostasis was established with eight units of cryoprecipitated antihemophilic factor, topical thrombin, and transfusion of 150 ml of packed cells. Fourteen hours after hemostasis had been established, the patient became febrile; his body temperature rose to 104 F (40 C) within five hours.