When Bloody Vomit Hides a Deeper Issue: A Case Series of Factitious Disorders with Hematemesis in Children

Abstract

Factitious disorder presenting as hematemesis (FDH) is a rare condition in the pediatric population. Diagnosis and management in such cases are complex and often delayed due to unnecessary investigations leading to a waste of useful resources. We present a case series of eleven children with bloody vomitus/vomitus simulating blood. There is a pattern of recurrent medical visits, hospitalizations, and invasive procedures without a medical cause. FDH should be considered as one of the differential diagnoses of hematemesis in children with an unknown cause. A detailed history taking is the key to diagnosis. Early recognition and a multidisciplinary approach are essential to ensure appropriate management and prevent unnecessary medical interventions.