1 Departments of Surgery and Psychiatry, The Hospital for Sick Children, and the University of Toronto, Toronto, Ontario
Self-mutilation, rare in children except for those suffering from schizophrenia or mental retardation, is difficult to diagnose and treat. The case history of a 13-year-old girl with bizarre abdominal complaints leading to an exploratory laparotomy and subsequent breakdown of her abdominal scar 5 months later, emphasizes some of the problems. No reason could be found for the scar separation and, after repeated and unsuccessful attempts to promote healing, we became convinced the patient was tampering with the wound. It appeared that her displacement as the focal point in the family with the remarriage of her mother and the stern discipline exhibited by her step-father motivated her to punish her parents and gain attention in this fashion.
Submitted on December 9, 1969