Self-Inflicted Hand Amputation without Replantation in a Patient with Body Integrity Identity Disorder: A Case Report.

Autor:	Ramkumar DB; Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts.; Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts.; Section of Orthopaedic Oncology, Department of Orthopaedic Surgery, Lahey Hospital and Medical Center, Burlington, Massachusetts., Brown MG; Dartmouth Geisel School of Medicine, Hanover, New Hampshire., Lewis CY; Dartmouth Geisel School of Medicine, Hanover, New Hampshire., Warren CE; Dartmouth Geisel School of Medicine, Hanover, New Hampshire., Fortney TA; Department of Orthopaedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire., Warhold LG; Department of Orthopaedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Jazyk:	angličtina
Zdroj:	JBJS case connector [JBJS Case Connect] 2021 Jul 06; Vol. 11 (3). Date of Electronic Publication: 2021 Jul 06.
DOI:	e20.00976
Abstrakt:	Case: We describe a patient who self-amputated his hand using a log splitter, because of a long-standing belief that the limb "did not belong to him." On admission, he refused replantation and was found to be nonpsychotic. He was diagnosed with body integrity identity disorder (BIID) and declared competent to make his own medical decisions. A revision amputation was performed. Conclusion: BIID is a challenging diagnosis that physicians treating traumatic injuries should be aware of. Many ethicists support elective amputation as a definitive treatment, because of potential harm reduction and because BIID does not respond to conservative modalities such as pharmacotherapy. Competing Interests: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/B548). (Copyright © 2021 by The Journal of Bone and Joint Surgery, Incorporated.)
Databáze:	MEDLINE
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