Method: 73 patients were performed gastric lavage by an improved technique with new equipment. All of the patients were monitored clinical signs (pulse rate, blood pressure, respiratory rate, SpO2, lung sound...) and tested (blood count, electrolyte, ECG, chest X-ray, toxic screening...) before and after doing gastric lavage. The results were compared to a retrospective study in 1998-2000 we found that complications are reduced significantly from 6.21% to 2.74%. In addition, there was not any severity complication; we only met two cases hypokalemia after doing gastric lavage. Conclusion: the improved technique with new equipment of gastric lavage would be safe for the patients, reduce significantly complication, and easy to implement.
Gastric Lavage ; Emergencies

In this paper, the design of a safe and multifunctional gastric lavage machine is presented. The microprocessor samples and analyzes the air pressure, time rate of pressure change, volume, and limit signals, then controls the relays and the electromagnetism valves to adjust the operating condition in real time. The machine has many functions, such as gastric lavage, aspirating, digital displaying, alarming, and so on.
Automation ; instrumentation ; Equipment Design ; Gastric Lavage ; instrumentation

Gastric lavage is one of gastrointestinal decontamination methods which have been controversial in the clinical toxicology field for a long time. Expert groups of American and European clinical toxicologists have published the position papers regarding gastric lavage three times since 1997. They recommended that gastric lavage should not be used as a routine procedure in the management of acute intoxication, because they thought that there is no certain evidence of improving clinical outcome by its use. However, the studies they reviewed were not well-controlled randomized trials, which cannot be conducted in the clinical toxicology field due to variability of patients and ethical problems. Therefore, the results from these studies should be interpreted with caution. They also insisted that gastric lavage can be undertaken within 60 minutes of ingestion. The limitation of one hour after ingestion is too arbitrary and may cause a lot of misunderstanding. Formation of pharmacobezoar or gastric hypomotility after ingestion may significantly delay the gastric emptying time so that gastric lavage can be useful even after several hours or more in case of highly toxic substances or severe intoxication. Furthermore, as there are a number of serious intoxication by toxic pesticides with large amount in suicidal attempts in Korea, it seems that gastric lavage may be used more frequently in Korea than in Western countries. When deciding whether or not to use gastric lavage, all the indications, contraindications, and possible adverse effects should be taken into account on the basis of risk-benefit analysis. If the procedure is decided to be done, it should only be performed by well-trained experts.
Decontamination ; Eating ; Gastric Emptying ; Gastric Lavage ; Humans ; Korea ; Pesticides ; Toxicology

Mucinous adenocarcinoma is a rare histologic type of gastric carcinoma. Most mucinous gastric carcinoma is diagnosed by histology after surgical resection. However, in this report, we preoperatively predicted the type of a tumor (mucinous type) from its characteristic endoscopic finding. An endoscopic examination showed a cauliflower-like mass on the upper body of the posterior wall. At first we could not find the mass because it was covered with a thick mucin-like substance. After gastric lavage and mucin aspiration we found a tumor mass which was surrounded with a characteristic mucin pool. Abdominal CT showed a 6 cm sized-mass connected with the gastric fundus. Total gastrectomy with esophagojejunostomy was performed. The pathology of the tumor proved to be a mucinous adenocarcinoma.
Adenocarcinoma* ; Adenocarcinoma, Mucinous ; Gastrectomy ; Gastric Fundus ; Gastric Lavage ; Gastric Mucins* ; Mucins* ; Pathology ; Tomography, X-Ray Computed

Decontamination ; methods ; Gastric Lavage ; methods ; Humans ; Poisoning ; therapy

No abstract available.
Administration, Oral ; *Colonoscopy ; Gastric Lavage/*methods ; Humans ; Magnesium Hydroxide/*administration &dosage ; Polyethylene Glycols/*administration &dosage

PURPOSE: To evaluate whether the early pulmonary irradiation can prevent or decrease the pulmonary damage and contribute to improve ultimate survival in paraquat lung. MATERIALS AND METHODS: From Jun. 1987 to Aug. 1993, thirty patients with paraquat poisoning were evaluated. Fourteen of these patients were received pulmonary irradiation(RT). All of the patients ere managed with aggressive supportive treatment such as gastric lavage, forced diuresis, antioxidant agents and antifibrosis agents. Ingested amounts of paraquat were estimated into three groups(A: minimal < about 5cc, B: mouthful 5-50 cc, C: Large > 50cc). Pulmonary irradiation was started within 24 hours after admission(from day 1 to day 11 after ingestion of paraquat). Both whole lungs were irradiated with AP/PA parallel opposing fields using C0-60 teletherapy machine. A total of 10Gy(2Gy/fr. X 5 days)was delivered without correction of lung density. RESULTS: In group A, all patients were alive regardless of pulmonary irradiation and in group C, all of the patients were died due o multi-organ failure, especially pulmonary fibrosis regardless of pulmonary irradiation. However, in group B, six of 7 patients(86%) with no RT were died due to respiratory failure, but 4 of 8 patients with RT were alive and 4 of 5 patients who received pulmonary irradiation within 4 days after ingestion of paraquat were all alive though radiological pulmonary fibrosis. All 3 patients who were received pulmonary irradiation after 4 days after ingestion wre died due to pulmonary fibrosis in spite of recovery from renal and hepatic toxicity. CONCLUSION: It is difficult to find out the effect of pulmonary irradiation on the course of the paraquat lung because the precise plasma and urine paraquat concentration were not available between control and irradiation groups. But early pulmonary irradiation within 4 days after paraquat poisoning with aggressive supportive treatment appears to decrease pulmonary toxicity and contribute survival in patients with mouthful ingestion of paraquat who are destined to have reversible renal and hepatic damage but irreversible pulmonary toxicity.
Diuresis ; Eating ; Gastric Lavage ; Humans ; Lung ; Mouth ; Paraquat* ; Plasma ; Poisoning* ; Pulmonary Fibrosis ; Respiratory Insufficiency

PURPOSE: This study was designed to prove the efficacy of neutralization with weak acid against strong alkali ingestion and to evaluate exothermic reaction of neutralization therapy. METHODS: 30 New Zealand White rabbits were anesthetized with intravenous injection of ketamine and xylazine. After gastric lavage was done, a orogastric catheter and a electric thermometer probe were inserted into stomach. And then the rabbits were divided into six groups. The first group was given 3M NaOH 16.5 mL only. The second and third groups were given 3M NaOH 16.5 mL and then 1M C H3COOH 52.14 mL one and three minutes later, respectively. The fourth and fifth groups were given tap water instead of CH3COOH, and the sixth group was given C H3COOH only. We monitored intragastric temperature continuously, compared arterial pHs before alkali infusion and 15 minutes later, measured gastric pH 15 minutes later, and examined pathologic findings of stomach after sacrificing. RESULTS: There was no significant thermal effect in all groups, and gastric pH of neutralization groups was much lower than alkali alone or dilution groups. Changes of arterial pH after 15 minutes were greater in alkali alone and dilution groups than neutralization groups. In gross and microscopic findings of stomach, only mucosal injuries were observed in neutralization groups, especially in one minute group. But all stomach layers were destroyed in alkali alone and dilution groups. CONCLUSION: Neutralization therapy never makes additional thermal injury, and has protective effects against local tissue destruction and systemic alkalemia. Dilution therapy shows little or no effects.
Alkalies* ; Catheters ; Eating* ; Gastric Lavage ; Hydrogen-Ion Concentration ; Injections, Intravenous ; Ketamine ; Rabbits ; Stomach ; Thermometers ; Water ; Xylazine

Chlorophenoxy herbicide poisoning is uncommon, but may produce severe sequelae. It's treatment is primarily the same as that used for poisonings with other drugs; gastric lavage, activated charcoal, etc. However, it's secondary treatment to enhance elimination has two options, alkaline diuresis or hemodialysis. We experienced a patient who had been poisoned with chlorophenoxy herbicide and had severe symptoms like comatose mentation, acute renal failure, rhadomyolysis, etc. The patient was treated by hemodialysis for 5 days and recovered from the acute state.
Acute Kidney Injury ; Charcoal ; Coma ; Diuresis ; Gastric Lavage ; Humans ; Poisoning ; Renal Dialysis*

PURPOSE: Activated charcoal (AC) has been widely used as a universal antidote. Currently, emergency medical centers in Korea cannot administer AC due to discontinuation of the supply of commercial ready-mixed AC suspension. This study was conducted to investigate the proportion of emergency medical centers that administer AC to poisoning patients and provide basic information for emergency physicians and toxicologists. METHODS: A prospective telephone survey of all of the included emergency medical institutions was conducted. The type of emergency medical institution, average annual number of patients admitted to the emergency department, annual average number of patients who were poisoned and whether the hospital currently utilizes gastric lavage and administration of AC were determined. RESULTS: AC was administered to poisoning patients in 40% of regional emergency medical centers, 59.3% of local emergency medical centers, and 45.9% of local emergency medical rooms. Overall, 37% of total emergency medical institutions did not administer AC due to discontinuation of the commercial ready-mixed AC suspension. Additionally, 77% of emergency physicians in institutions without AC knew AC is necessary for poisoning patients. The rate of vomiting experienced by the medical staff according to types of charcoal showed that the average rate of vomiting was 33% for commercial ready-mixed activated charcoal suspension and 51% for self-prepared charcoal powder (p=0.02). CONCLUSION: AC should be secured promptly in emergency medical institutions. Before the supply of commercial ready-mixed AC suspension becomes again it is essential to develop a standardized regimen for self-preparation of charcoal powder and to educate emergency physicians and toxicologists to its use.
Charcoal* ; Emergencies* ; Emergency Service, Hospital ; Gastric Lavage ; Humans ; Korea* ; Medical Staff ; Poisoning* ; Prospective Studies ; Telephone ; Vomiting