Lu YL, Hu J, Zhang LY, Cen XY, Yang DH, Yu AY. Duodenal perforation after organophosphorus poisoning: A case report. World J Clin Cases 2021; 9(27): 8186-8191 [PMID: 34621879 DOI: 10.12998/wjcc.v9.i27.8186]
Corresponding Author of This Article
An-Yong Yu, MD, Chief physician, Professor, Department of Emergency Medicine, Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Road, Zunyi 563003, Guizhou Province, China. anyongyu750811@126.com
Research Domain of This Article
Emergency Medicine
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yuan-Lan Lu, Lu-Ying Zhang, Xiang-Yin Cen, Deng-Hui Yang, An-Yong Yu, Department of Emergency Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
Jie Hu, Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
Author contributions: Lu YL and Hu J reviewed the literature and contributed to manuscript drafting; Zhang LY, Cen XY, and Yang DH analyzed and interpreted the imaging findings and contributed to manuscript drafting; Yu AY revised the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Supported bythe National Natural Science Foundation of China, No. 81560217; and the Zunyi Science and Technology Project, No. ZunshiKeheHZ(2019)95.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: An-Yong Yu, MD, Chief physician, Professor, Department of Emergency Medicine, Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Road, Zunyi 563003, Guizhou Province, China. anyongyu750811@126.com
Received: May 7, 2021 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
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
