Acute arsenic self-poisoning for suicidal purpose in a dentist: a case report.
Arsenic is a classical poison that has been historically used since ancient times for homicidal purposes. More recently, episodes of deliberate or unintentional arsenic self-poisoning have been increasingly reported. We describe here a case of a 77-year old male patient with a history of major depression, who attempted suicide by ingestion of 4 g of arsenic trioxide. The man, a dentist by profession, used arsenic preparations for pulp devitalization. The patient was admitted to our hospital 5 h after arsenic ingestion with nausea and vomiting. Plain radiograph of the abdomen showed radio-opaque material in the stomach and small intestine. Nasogastric lavage, activated charcoal, and chelators were used to remove arsenic. On day 3, endoscopy disclosed the presence of gastritis and superficial ulcers. The patient developed significant anemia (Hb: 8.7 g/dL on day 7) without significant signs of hemolysis. He gradually recovered from anemia within 5 months. The patient did not suffer any adverse outcome in spite of having ingesting 4 g of arsenic, approximately 20 times the lethal dose.
Department of Internal Medicine, Uludag University Medical School, Bursa, Turkey. yusufyilmaz@uludag.edu.tr
Y
Y
Yilmaz
E
E
Armagan
Of
O
Olmez
M
M
Esen
N
N
Alkis
E
E
Dolar
D000208:Acute Disease; D000368:Aged; D020261:Arsenic Poisoning / Q000473:pathology* / Q000628:therapy; D000077237:Arsenic Trioxide; D001152:Arsenicals; D002606:Charcoal / Q000627:therapeutic use; D002614:Chelating Agents / Q000627:therapeutic use; D015913:Chelation Therapy; D004112:Dimercaprol / Q000627:therapeutic use; D005751:Gastric Lavage / Q000379:methods; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods; D008297:Male; D010087:Oxides / Q000506:poisoning*; D013406:Suicide, Attempted; D016896:Treatment Outcome
D001152:Arsenicals; D002614:Chelating Agents; D010087:Oxides; D004112:Dimercaprol; D002606:Charcoal; D000077237:Arsenic Trioxide