title: Endoscopic removal of slow release clomipramine bezoars in two cases of acute poisoning.
abstract: BACKGROUND
  Acute gastroscopy is seldom advocated in cases of drug overdose. However, this intervention is sometimes recommended in cases where a pharmacobezoar of toxic tablets has formed.
  
  
  METHODS
  We describe two patients who were admitted after major ingestion of slow release clomipramine. In one case an abdominal x-ray was highly suspicious of a large pharmacobezoar in the stomach and in the other case a tablet conglomerate totally obstructed the oesophagus. Both conditions were successfully managed by acute gastroscopy.
  
  
  CONCLUSIONS
  There are limited and inconclusive recommendations in the literature concerning the optimal treatment of pharmacobezoars.
  
  
  CONCLUSIONS
  This article provides further evidence that slow release clomipramine may be capable of forming a radio-opaque pharmacobezoar. The clinical courses in these two cases suggest that tablet removal by gastroscopy should be considered in selected cases of drug poisoning. Suspicion of a pharmacobezoar may warrant diagnostic investigations such as imaging studies and endoscopy.
authors: Swedish Poisons Information Centre, Stockholm, Sweden. jonas.hojer@apoteket.se
authors: Jones
authors: J
authors: Höjer
authors: Mark
authors: M
authors: Personne
mesh_terms: D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000506:poisoning*; D001630:Bezoars / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000601:surgery*; D002997:Clomipramine / Q000506:poisoning*; D004947:Esophagus; D005260:Female; D005773:Gastroscopy; D006801:Humans; D011859:Radiography; D013270:Stomach; D016896:Treatment Outcome
chemical_list: D000929:Antidepressive Agents, Tricyclic; D002997:Clomipramine