Published online Sep 26, 2021. doi: 10.12998/wjcc.v9.i27.8186
Peer-review started: May 7, 2021
First decision: June 6, 2021
Revised: June 18, 2021
Accepted: July 19, 2021
Article in press: July 19, 2021
Published online: September 26, 2021
Processing time: 132 Days and 8 Hours
Organophosphorus poisoning (OP) is one of the common critical conditions in emergency departments in China, which is usually caused by suicide by taking oral drugs. Patients with severe OP have disturbance of consciousness, respiratory failure, toxic shock, gastrointestinal dysfunction, and so on. As far as we know, the perforation of the duodenum caused by OP has not been reported yet.
A 33-year-old male patient suffered from acute severe OP, associated with abdominal pain. Multiple computed tomography scans of the upper abdomen showed no evidence of intestinal perforation. However, retrograde digital subtraction angiography, performed via an abdominal drainage tube, revealed duodenal perforation. After conservative treatment, the symptoms eased and the patient was discharged from hospital.
Clinicians should pay close attention to gastrointestinal dysfunction and abdominal signs in patients with severe OP. If clinical manifestation and vital signs cannot be explained by common complications, stress duodenal ulcer or perforation should be highly suspected.
Core Tip: Organophosphorus poisoning is one of the common critical conditions in emergency departments in China and is usually caused by suicide. However, duodenal perforation caused by organophosphorus poisoning has not yet been reported. In this case, organophosphorus poisoning induced duodenal perforation, and the potential mechanism involves drug toxicity, physical injury caused by gastric lavage, or a stress response to acute poisoning, and severe shock.