Efficacy of abdominal computed tomography and nasogastric tube in acute poisoning patients.
Abdominal computed tomography aids in the evaluation of the conditions in the stomach and will decrease needless gastric lavage in acute poisoning patients. A 16-year-old girl with a history of schizophrenia with depressive disorder was taken to our hospital. Her Glasgow Coma Scale was 8. Symptoms related to anticholinergic effects were strongly present. Her electrocardiogram showed sinus tachycardia with 60 milliseconds of QRS duration. Computed tomography images showed that the patient had a large amount of debris derived from tablets in her stomach and duodenum. We performed gastric aspiration through a nasogastric tube and not gastric lavage, and it took 5 minutes to complete the procedure. We administered activated charcoal 3 times. Intubation was not performed. Other than tonic-clonic seizure that was observed once, neither cardiovascular nor neurologic symptoms were observed. She recovered fully and admitted that she had ingested more than a hundred tablets almost 10 hours before being brought to our hospital. Computed tomography images show a cluster of tablets and debris to be of a higher density than tissues; this allows quantitative and qualitative evaluations to be performed. We were able to treat the patient with effective use of nasogastric tube.
Kimura
Yoshinobu
Y
Department of Anesthesia, Takikawa Municipal Hospital, Takikawa 073-0022, Japan. sherma@gf6.so-net.ne.jp
Kamada
Yasuhiro
Y
Kimura
Saori
S
D000208:Acute Disease; D000293:Adolescent; D002606:Charcoal / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal; D011041:Poisoning / Q000000981:diagnostic imaging* / Q000628:therapy*; D011860:Radiography, Abdominal; D013270:Stomach / Q000000981:diagnostic imaging; D013396:Suction / Q000295:instrumentation*; D013406:Suicide, Attempted; D014057:Tomography, X-Ray Computed
D002606:Charcoal