Images in acute diquat poisoning, including hepatic portal venous gas and gastrointestinal pneumatosis on computed tomography.

IF 3 3区医学 Q2 TOXICOLOGY Clinical Toxicology Pub Date : 2024-10-01 Epub Date: 2024-09-05 DOI:10.1080/15563650.2024.2398773

Guangcai Yu, Jieru Wang, Baotian Kan, Wei Li, Xiangdong Jian

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Abstract

Introduction: Severe diquat poisoning often leads to acute kidney injury, gastrointestinal injury, paralytic ileus, rhabdomyolysis, respiratory failure, refractory circulatory failure, and brainstem damage.

Case summary: A previously healthy 38-year-old man was admitted to our hospital with anuria, mild abdominal distension, and calf pain after ingesting diquat (200 g/L) 100 mL approximately 13 h before presentation. His blood diquat concentration was 8.14 µg/L on admission. Gastrointestinal catharsis, haemoperfusion, and haemodiafiltration were performed. Subsequently, he developed marked abdominal distention, impaired consciousness, hypotension, and respiratory failure, leading to death.

Images: Computed tomography revealed gas accumulation in the portal venous system and mesenteric vessels. Moreover, gastrointestinal pneumatosis was present. Computed tomography also revealed changes in the lung, brainstem, and calf muscles.

Conclusion: Diquat poisoning can result in acute kidney injury, hepatic injury, gastrointestinal injury, paralytic ileus, rhabdomyolysis, refractory circulatory failure, brainstem damage, and hepatic portal venous gas, all observed in this patient.

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急性敌草快中毒的图像，包括计算机断层扫描上的肝门静脉气体和胃肠道积气。

导言：严重的敌草快中毒通常会导致急性肾损伤、胃肠道损伤、麻痹性回肠炎、横纹肌溶解症、呼吸衰竭、难治性循环衰竭和脑干损伤。病例摘要：一名之前身体健康的 38 岁男子在发病前约 13 小时因摄入敌草快（200 克/升）100 毫升后出现无尿、轻度腹胀和小腿疼痛而被送入我院。入院时其血液中的敌草快浓度为 8.14 µg/L。对他进行了胃肠道灌洗、血液灌流和血液滤过。随后，他出现明显腹胀、意识障碍、低血压和呼吸衰竭，最终死亡：计算机断层扫描显示门静脉系统和肠系膜血管内有气体积聚。此外，还出现了胃肠道积气。计算机断层扫描还显示肺部、脑干和小腿肌肉发生变化：结论：毒死蜱中毒可导致急性肾损伤、肝损伤、胃肠道损伤、麻痹性回肠炎、横纹肌溶解症、难治性循环衰竭、脑干损伤和肝门静脉积气，这些在该患者身上都能观察到。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Toxicology 医学-毒理学

CiteScore

5.70

自引率

12.10%

发文量

148

审稿时长

4-8 weeks

期刊介绍： clinical Toxicology publishes peer-reviewed scientific research and clinical advances in clinical toxicology. The journal reflects the professional concerns and best scientific judgment of its sponsors, the American Academy of Clinical Toxicology, the European Association of Poisons Centres and Clinical Toxicologists, the American Association of Poison Control Centers and the Asia Pacific Association of Medical Toxicology and, as such, is the leading international journal in the specialty.