Repetitive endoscopy and continuous alkaline gastric irrigation in a case of arsenic poisoning.
(2000) Journal of Toxicology. Clinical Toxicology — Vol. 38, n° 5, p. 471-476 (2000)
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- Abstract
- BACKGROUND: The poor prognosis of patients with persistent gastrointestinal radio-opacities after oral arsenic poisoning supports efficient gastrointestinal decontamination as critical for survival. In a case of massive arsenic ingestion, we performed repetitive gastric endoscopy and a continuous alkaline irrigation of the stomach over several days. CASE REPORT: A 41-year-old woman was admitted 4 hours after intentional ingestion of trivalent arsenic powder 5 g. The admission abdominal X-ray confirmed the presence of multiple gastric opacities. Initial treatment was gastric lavage with normal saline, dimercaprol chelation, and supportive therapy. Since gastric opacities persisted on the abdominal X-ray at 34 hours despite repeated gastric lavage, a gastroscopy was performed showing nonremovable agglomerates. In an attempt to achieve further gastric decontamination, we performed a continuous gastric alkaline irrigation. After 3 days of alkaline irrigation, the abdomen was normal on X-ray but the gastroscopy still showed arsenic concretions. Alkaline irrigation was continued for another 3 days until total disappearance of arsenic agglomerates at the gastroscopy. Admission urinary arsenic was 3663 microg/L. A total of 46.2 mg of inorganic arsenic, or less than 1% the ingested dose, was extracted from the stomach by this technique. The patient was discharged from the intensive care unit 20 days after admission without sequelae.
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Michaux, I., Haufroid, V., Dive, A.-M., Buchet, J.-P., Bulpa, P., Mahieu, P., & Installé, E. (2000). Repetitive endoscopy and continuous alkaline gastric irrigation in a case of arsenic poisoning. Journal of Toxicology. Clinical Toxicology, 38(5), 471-476. https://doi.org/10.1081/CLT-100102005 (Original work published 2000)