![]() The serum iron was 2 µg/L (normal range 10–100 µg/L) and the transferrin saturation was 2%, confirming severe iron deficiency. There was no family history of thalassaemia, thus the most likely cause of such a low mean cell volume was iron deficiency. The X-ray opacities are mainly in the colon Case study continuedĪ full blood count revealed microcytic anaemia with a haemoglobin of 76 g/L (normal range 110–145 g/L) and a mean cell volume of 54 fL (normal range 72–87 fL). ![]() Abdominal X-ray displaying typical features of soil pica. Barium that has entered diverticula from previous barium studies has a different and characteristic appearance.įigure 1. Kidney and gall bladder stones produce opacities restricted to the region of the organs concerned. Tuberculosis, calcified lymph nodes and enteroliths can also cause multiple abdominal opacities, but not on the scale and pancolonic distribution of geophagia. 1 Iron and potassium tablets are also X-ray opaque, but are seen on X-ray to be in the stomach, not the colon. In soil pica, or geophagia, the majority of X-ray opaque material is found in the colon. The child’s mother then revealed that the child frequently ate soil. Bowel sounds were of normal frequency but high pitched.Īn abdominal X-ray revealed numerous irregular X-ray opaque objects ( Figure 1). ![]() A child, 3 years of age, presented to a district hospital emergency department with a 4 day history of loss of appetite and a 2 day history of passing, with apparent difficulty, pale, thick, pasty faeces.Įxamination revealed a tired looking child, normal vital signs, moist mucous membranes, and a moderately distended abdomen with some mild left upper quadrant tenderness.
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