title: Multiple dose-activated charcoal as a cause of acute appendicitis.
abstract: We presented a case of a 55-year-old woman who intentionally ingested an unknown amount of carbosulfan, a carbamate insecticide. On admission, her clinical findings were coma, pinpoint pupils, hypersalivation, respiratory failure, bradycardia, and hypotension. Hertrachea was intubated after suction of secretions, and atropine was administered intravenously. After gastric lavage, multiple doses of activated charcoal were instilled through the nasogastric tube over five days (total doses of 840 g). On the fourteenth day, she developed right-lower quadrant abdominal pain, anorexia, nausea, and vomiting, and she underwent an appendectomy. On pathologic examination of the specimen, particles of activated charcoal were seen within the dilated part of the appendiculer lumen. The patient was discharged from the hospital after antidepressant therapy at the psychiatry clinic. This case documents that multiple doses of activated charcoal may be associated with acute appendicitis.
authors.affiliation: Department of Anesthesiology and Reanimation, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey. erogluah@mynet.com
authors.forename: Ahmet
authors.initials: A
authors.lastname: Eroglu
authors.forename: Uzer
authors.initials: U
authors.lastname: Kucuktulu
authors.forename: Nesrin
authors.initials: N
authors.lastname: Erciyes
authors.forename: Havvanur
authors.initials: H
authors.lastname: Turgutalp
mesh_terms: D000208:Acute Disease; D000328:Adult; D000931:Antidotes / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001064:Appendicitis / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D001065:Appendix / Q000473:pathology; D002219:Carbamates / Q000506:poisoning; D002606:Charcoal / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D003866:Depressive Disorder / Q000150:complications; D005260:Female; D006801:Humans; D007306:Insecticides / Q000506:poisoning; D013406:Suicide, Attempted
chemical_list: D000931:Antidotes; D002219:Carbamates; D007306:Insecticides; D002606:Charcoal; C035038:carbosulfan