Hemoperfusion in white phosphorus poisoning.
Case report.
DOI:
https://doi.org/10.56867/38Keywords:
Phosphorus, liver failure, hemoperfusion, poisoning, intoxication, case reportAbstract
Introduction: White phosphorus is commonly used in pyrotechnic products. When ingested, it can cause gastrointestinal, hepatic, and renal alterations, circulatory collapse, and neurotoxicity. There is no antidote, and a treatment option may be hemoperfusion, which is why the management of this case is presented.
Clinical case: 26-year-old man who comes with ingestion of 100 mg white phosphorus in the form of 5 pyrotechnic pills (1.41 mg/kg) 5 hours previously. The physical examination showed arterial hypertension 158/92 mm Hg; the rest of the examination was regular. Hemoglobin 17.8 g/dl, Cholinesterase 13216 U/L, ketonuria 150 mg/dl, toxicology negative for amphetamines, barbiturates, benzodiazepines, cocaine, marijuana, methadone, methamphetamines, opiates, and antidepressants.
Management: Gastric lavage was performed with 10% sodium bicarbonate (20 ampoules) plus 1000 ml of 0.9% Sodium Chloride. He was hydrated with 0.9% Saline Solution 100 ml/hour, Omeprazole 40 mg intravenously, and Acetylcysteine in continuous infusion. Vascular access was placed, and he underwent four sessions of Hemoperfusion (Jafron HA230 activated carbon) every 12 hours for 3 hours.
Evolution: In the third year, there was an increase in TGP of 1002 U/l; the INR was 4.56. Severe acute hepatitis was diagnosed without encephalopathy and acute liver failure. Four additional sessions of hemoperfusion were performed, and vitamin K and Acetylcysteine were simultaneously received. On the 6th day, the TGP value decreased to 128 U/L and the
INR normalized. He was discharged in good condition.
Conclusion: Hemoperfusion in 8 sessions, in this case of severe white phosphorus poisoning, prevented liver failure and mortality.

Downloads
Published
Issue
Section
License
Copyright (c) 2024 María José Pinos Cedeño, Sebastián Guacho Guacho, Anthony Rosero Portilla, Santiago David Silva Tobar (Author)

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.