Ishtiaq Ahmed Chaudhary, Samiullah, Wahid Bakhsh Sajid.
Munchausen Syndrome Not An Uncommon Condition.
Pak Armed Forces Med J Jan ;57(2):158-61.

A 52 years old unmarried, ex-serviceman, presented with small paraumblical hernia for which Mayo`s repair was done. He requested for discharge on 4th postoperative day due to some emergency at home and was thus discharged on request. After three months he reported back with recurrence of hernia. Mesh repair was done. During convalescence, his wound got infected superficially and few scratch marks were noticed around the wound. During his stay in hospital he started making allegations on ward staff and junior doctors regarding their behavior and efficiency. He asked for discharge many times by giving certain domestic reasons but he was sent home after complete recovery. He again did not report for follow up during postoperative period. After about six months he reported to SOME senior non-medical official whom he narrated his history in a dramatic way, who sent him to hospital for admission. This time hit recurrence was large with a wide defect it abdominal wall. Superficial ulcers and scratcl marks were found over the skin. He was admitted and complete assessment for the cause of recurrence was done but no etiologic, or aggravating factors were found. He was kept under close observation postoperatively for about si weeks in hospital. During his stay in hospital he repeatedly asked for discharge, made allegations on ward staff and refused to take treatment. He developed superficial ulcer over the operated area. He was kept under surveillance and it was revealed that he used to scratch intentionally and create these ulcers over the skin. On discharge he was handed over to his brother and complete counseling was done regardin his illness. After discharge he again The board concluded that he was a case of "Munchausen`s syndrome". For last 4 years he had 20 hospital admissions and countless outpatient consultations mostly with excoriation after scratching thin skin

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