title: Ethylene glycol toxicity associated with ischemia, perforation, and colonic oxalate crystal deposition.
abstract: Severe ethylene glycol toxicity can cause profound morbidity and is almost universally fatal if untreated. Central nervous system depression with intoxication, pulmonary edema, and acute oliguric renal failure with crystalluria are among the most commonly encountered complications of ingestion. The previously reported gastrointestinal side effects of ethylene glycol toxicity are mostly nonspecific, including nausea, abdominal pain, and cramping. In addition, hepatic damage due to calcium oxalate deposition has been reported. We describe a patient who developed acute colonic ischemia following ethylene glycol intoxication. Three months after the ingestion, the patient presented with severe abdominal pain secondary to a colonic stricture and perforation, necessitating emergent colectomy. Histology of the resected colon revealed polarizable polyhedral crystals suggestive of oxalate deposition. The pathophysiology underlying ethylene glycol intoxication, treatment strategies, and gastrointestinal toxicity are discussed.
authors.affiliation: Section of General Internal Medicine, Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, USA.
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Gardner
authors.forename: Harold L
authors.initials: HL
authors.lastname: Manning
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Beelen
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Cimis
authors.forename: Justin M M
authors.initials: JM
authors.lastname: Cates
authors.forename: Lionel D
authors.initials: LD
authors.lastname: Lewis
mesh_terms: D003082:Colectomy; D003106:Colon / Q000098:blood supply / Q000737:chemistry / Q000473:pathology*; D003460:Crystallization; D019855:Ethylene Glycol / Q000506:poisoning*; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology*; D007511:Ischemia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010070:Oxalates / Q000737:chemistry*; D011041:Poisoning / Q000150:complications / Q000175:diagnosis; D014057:Tomography, X-Ray Computed
chemical_list: D010070:Oxalates; D019855:Ethylene Glycol