A fatal case of acute arsenic poisoning.
- Author:
Hyung Soo WI
1
;
Seung Hee LEE
;
Young Hwan SEO
;
Jeong Goo KIM
;
Gi Chang KIM
;
Chang Soo JANG
;
Hyung Keun ROH
Author Information
1. Department of Internal Medicine, College of Medicine, Inha University, Incheon, Korea. keunroh@inha.ac.kr
- Publication Type:Case Report
- Keywords:
Arsenic;
Acute;
Poisoning
- MeSH:
Abdominal Pain;
Acidosis;
Acute Kidney Injury;
Aged;
Arsenic Poisoning*;
Arsenic*;
Cardiotonic Agents;
Charcoal;
Diarrhea;
Eating;
Electrocardiography;
Emergency Service, Hospital;
Gastrointestinal Tract;
Humans;
Hypotension;
Myocardial Infarction;
Oxygen;
Poisoning;
Shock;
Stomach;
Suicide, Attempted;
Thorax;
Vomiting
- From:Korean Journal of Medicine
2005;69(1):101-106
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Arsenic trioxide is the most prevalent natural inorganic form of arsenic, which is a widely used heavy metal and is ubiquitously distributed in the environment. A 71-year-old man ingested about 10 g of arsenic trioxide powder in an attempted suicide. He developed severe vomiting, watery diarrhea and abdominal pain, and he presented to the emergency room 15 hours after the ingestion. On admission he was slightly drowsy, but shocked. He showed metabolic acidosis, acute renal failure and abnormal electrocardiogram suspecting myocardial infarction. The chest and abdominal X-rays revealed radiopaque materials in the stomach and small bowel. The stomach was irrigated via a nasogastric tube and activated charcoal was given to bind unabsorbed arsenic. The whole bowel irrigation was tried to remove the remained arsenic in the gastrointestinal tract and BAL (British anti-lewisite) was repeatedly administrated. Despite of intensive supporting management with supplemental oxygen, aggressive volume expansion, correction of metabolic disturbances and administration of cardiotonic agents, he developed progressive hypotension and died 42 hours after the ingestion. Random urine arsenic concentration, which was collected at the time of admission, but confirmed after death, was 3,564 microgram/L.
