Caustic Injury After Organophosphate Poisoning.

Caustic Injury After Organophosphate Poisoning. Rev Esp Enferm Dig. 2020 Dec 03;: Authors: Mascarenhas Saraiva M, Ribeiro T, Vilas-Boas F, Macedo G Abstract An 83-year-old man was brought to the emergency room after ingesting an unknown dose of dimethoate, an organophosphate pesticide. He had been previously diagnosed with depression but had no previous suicide attempts. The admission Glasgow Coma Scale score was 3 and he had miotic pupils and copious oropharyngeal secretions. The patient was hemodynamically stable, mildly tachypneic (respiratory rate 22/minute), and nonfebrile. Lab workup revealed normal complete blood count (Hb 14,7 g/dL, platelets 178000/µL); normal liver tests; no coagulopathy. Low acetylcholinesterase levels confirmed organophosphate poisoning. He was admitted in the intensive care unit (ICU) under treatment with obidoxime. During the ICU stay the patient developed increasingly severe anemia and thrombocytopenia. At the fourth day in ICU, blood was recovered from the nasogastric tube with concomitant drop in hemoglobin values (from 12 to 9 g/dL). An esophagogastroduodenoscopy was performed and revealed extensive necrosis of body and fundus, with areas of deep ulceration, in relation with gastric caustic injury (Zargar classification 3B). Further clinical course was complicated by multiorgan dysfunction. The patient died ten days after admission. PMID: 33267602 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research