Metrika

  • citati u SCIndeksu: 0
  • citati u CrossRef-u:0
  • citati u Google Scholaru:[]
  • posete u poslednjih 30 dana:16
  • preuzimanja u poslednjih 30 dana:13

Sadržaj

članak: 1 od 1  
2012, vol. 46, br. 4, str. 237-240
Fatalni infarkt miokarda nakon namerne ingestije sumporne kiseline
aKlinički centar Kragujevac, Centar za urgentnu medicinu, Srbija
bKlinički centar Kragujevac, Centar za anesteziju i reanimaciju, Srbija

e-adresamatejamm.radovanovic@gmail.com
Ključne reči: toksikologija; trovanje; suicid, pokušani; sumporna kiselina; infarkt miokarda
Sažetak
Trovanja neorganskim kiselinama su relativno česta. Ona su češće zadesna, ali se beleže i pokušaji samoubistava neorganskim kiselinama. Jake kiseline izazivaju koagulacionu nekrozu i mogu da dovedu do perforacije organa proksimalnog dela digestivnog trakta. Trovanja kiselinama takođe rezultuju pojavom metaboličke acidoze, hemolize i bubrežne slabosti. Cirkulatorni kolaps je najčešći sistemski efekat trovanja kiselinama, dok se infarkt miokarda udružen sa ovom vrstom trovanja izuzetno retko opisuje. U radu je prikazana bolesnica od 61 godine, hospitalizovana sat vremena nakon namerne ingestije 20 ml sumporne kiseline. Bolesnica je u trenutku hospitalizacije bila u besvesnom stanju (Glazgov koma skor 6), sa znacima respiratorne insuficijencije, cirkulatornog kolapsa i acidoze (pH 6,87, bazni eksces - 29,6 mmol/l). Inicijalnim EKG pregledom nisu registrovani znaci miokardne ishemije/lezije, ali su 90 minuta od prijema uočeni znaci inferolateralnog infarkta miokarda leve komore sa ST elevacijom do 0,8 mV. Uprkos preduzetim merama intenzivnog lečenja osam sati nakon prijema registrovana je smrt. Mada je pojava akutnog infarkta miokarda kod trovanja anorganskim kiselinama retka, ponekad ingestija sumporne kiseline može da dovede do razvoja teškog infarkta miokarda i rezultuje smrtnim ishodom. Često ponavljanje elektrokardiografskih pregleda i EKG monitoring može doprineti pravovremenom otkrivanju infarkta miokarda i preduzimanju adekvatnih terapijskih mera.
Reference
Akbaba, M., Nazlican, E., Demirhindi, H., Sütoluk, Z., Gökel, Y. (2007) Etiological and demographical characteristics of acute adult poisoning in Adana, Turkey. Human & experimental toxicology, 26(5): 401-6
Bailey, B., Loebstein, R., Lai, C., McGuigan, M.A. (1997) Two cases of chlorinated hydrocarbon-associated myocardial ischemia. Veterinary and human toxicology, 39(5): 298-301
Bose, T.K., Basu, R.K., Biswas, B., de J.N., Majumdar, B.C., Datta, S. (1999) Cardiovascular effects of yellow oleander ingestion. Journal of the Indian Medical Association, 97(10): 407-10
Brahmi, N., Kouraichi, N., Blel, Y., Mourali, S., Thabet, H., Mechmeche, R., Amamou, M. (2006) Acute myocarditis and myocardial infarction induced by Paraphenylenediamine poisoning. Interest of angiocoronarography. International journal of cardiology, 113(3): E93-5
Burge, M., Hunsaker, J.C., Davis, G.J. (2009) Death of a toddler due to ingestion of sulfuric acid at a clandestine home methamphetamine laboratory. Forensic science, medicine, and pathology, 5(4): 298-301
Chang, J., Liu, N., Pai, B.C., Liu, Y., Tsai, M., Lee, C., Chu, Y., Lin, C., Chiu, C., Cheng, H. (2011) The role of age in predicting the outcome of caustic ingestion in adults: A retrospective analysis. BMC gastroenterology / BMC Gastroenterol, 11: 72
Cibisev, A., Nikolova-Todorova, Z., Bozinovska, C., Petrovski, D., Spasovski, G. (2007) Epidemiology of severe poisonings caused by ingestion of caustic substances. Prilozi / Makedonska akademija na naukite i umetnostite, Oddelenie za biološki i medicinski nauki, 28(2): 171-83
Corsi, P.R., Hoyos, M.B., Rasslan, S., de Viana, A.T., Gagliardi, D. (2000) Esophagogastric acute injury caused by a chemical agent. Revista da Associação Médica Brasileira, 46(2): 98-105
Ertekin, C., Alimoglu, O., Akyildiz, H., Guloglu, R., Taviloglu, K. (2004) The results of caustic ingestions. Hepato-gastroenterology, 51(59): 1397-400
Huang, C., Wu, H., Lee, Y. (2010) Extensive tracheobronchitis and lung perforation after alkaline caustic aspiration. Annals of thoracic surgery, 89(5): 1670-3
Jovančević, L., Dankuc, D. (2008) Dijagnostičko-terapijski pristup bolesnicima nakon ingestije korozivnih supstanci. Medicinski pregled, =61, 41-46
Jović-Stošić, J., Babić, G., Todorović, V. (2009) Fatalno trovanje dikvatom. Vojnosanitetski pregled, 66(6): 477-481
Kamiński, D. (2001) Noninvasive mechanical ventilation. Polskie Archiwum Medycyny Wewnętrznej, 105 Suppl: 235-7
Kaushik, R.M., Kaushik, R., Mahajan, S.K. (2007) Subendocardial infarction in a young survivor of aluminium phosphide poisoning. Human & experimental toxicology, 26(5): 457-60
Kose, A., Kose, B., Açikalin, A., Gunay, N., Yildirim, C. (2009) Myocardial infarction, acute ischemic stroke, and hyperglycemia triggered by acute chlorine gas inhalation. American journal of emergency medicine, 27(8): 1022.e1-4
Krishan, V.I.J. (2008) Textbook of forensic medicine and toxicology: Principles and practice. Noida: Elselvier, 4th ed
Meier, M. (2002) Suicide attempt with insulin as a cause of myocardial infarct. Zeitschrift für Kardiologie, 91(2): 178-81
Radovanović, M., Milisavljević, S. (2002) Elektrokardiografske promene kod bolesnika sa spontanim hematopneumotoraksom. Medicus, vol. 3, br. 2, str. 54-57
Rodrigez, M.A., Meza, F.J.L. (2003) Clinicalepidemiological characteristics in caustics ingestion patient in the Hipólito Unanue National Hospital. Rev Gastronetrol Peru, 23: 115-125
Rosenzweig, J.S., van Deusen, S.K., Okpara, O., Datillo, P.A., Briggs, W.M., Birkhahn, R.H. (2008) Authorship, collaboration, and predictors of extramural funding in the emergency medicine literature. American Journal of Emergency Medicine, 26(1): 5-9
Satar, S., Topal, M., Kozaci, N. (2004) Ingestion of caustic substances by adults. American journal of therapeutics, 11(4): 258-61
Su, J.M., Hsu, H.K., Chang, H.C., Hsu, W.H. (1994) Management for acute corrosive injury of upper gastrointestinal tract. Zhonghua yi xue za zhi, 54(1): 20-5
Tüfekçi, I.B., Curgunlu, A., Sirin, F. (2004) Characteristics of acute adult poisoning cases admitted to a university hospital in Istanbul. Human & experimental toxicology, 23(7): 347-51
Ulmeanu, C., Nitescu, G.V.G. (2005) Mortality rate in acute poisoning in a pediatric toxicology department. Przegla̧d lekarski, 62(6): 453-5
Vijayanath, V., Raju, G.M., Nagaraja, R.K., Anitha, M.R. (2010) Suicidal acid injury: A case report. J Indian acad forensic med, 32: 347-8
Yanturali, S., Aksay, E., Atilla, R. (2005) Acute myocardial infarction after hydrochloric acid ingestion. Mount Sinai journal of medicine, New York, 72(6): 409-12
 

O članku

jezik rada: srpski
vrsta rada: prikaz slučaja
DOI: 10.5937/mckg46-1763
objavljen u SCIndeksu: 25.01.2013.

Povezani članci

Nema povezanih članaka