A Challenging Case of Acute Mercury Toxicity

Ali Nayfeh, Thamer Kassim, Noor Addasi, Faysal Alghoula, Christopher Holewinski, Zachary Depew

Research output: Contribution to journalArticle

Abstract

Background. Mercury exists in multiple forms: elemental, organic, and inorganic. Its toxic manifestations depend on the type and magnitude of exposure. The role of colonoscopic decompression in acute mercury toxicity is still unclear. We present a case of acute elemental mercury toxicity secondary to mercury ingestion, which markedly improved with colonoscopic decompression. Clinical Case. A 54-year-old male presented to the ED five days after ingesting five ounces (148 cubic centimeters) of elemental mercury. Examination was only significant for a distended abdomen. Labs showed elevated serum and urine mercury levels. An abdominal radiograph showed radiopaque material throughout the colon. Succimer and laxatives were initiated. The patient had recurrent bowel movements, and serial radiographs showed interval decrease of mercury in the descending colon with interval increase in the cecum and ascending colon. Colonoscopic decompression was done successfully. The colon was evacuated, and a repeat radiograph showed decreased hyperdense material in the colon. Three months later, a repeat radiograph showed no hyperdense material in the colon. Conclusion. Ingested elemental mercury can be retained in the colon. Although there are no established guidelines for colonoscopic decompression, our patient showed significant improvement. We believe further studies on this subject are needed to guide management practices.

LanguageEnglish (US)
Article number1010678
JournalCase Reports in Medicine
Volume2018
DOIs
StatePublished - Jan 1 2018

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Mercury
Colon
Decompression
Succimer
Descending Colon
Ascending Colon
Laxatives
Cecum
Poisons
Practice Management
Abdomen
Eating
Urine
Guidelines
Serum

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Nayfeh, A., Kassim, T., Addasi, N., Alghoula, F., Holewinski, C., & Depew, Z. (2018). A Challenging Case of Acute Mercury Toxicity. Case Reports in Medicine, 2018, [1010678]. https://doi.org/10.1155/2018/1010678

A Challenging Case of Acute Mercury Toxicity. / Nayfeh, Ali; Kassim, Thamer; Addasi, Noor; Alghoula, Faysal; Holewinski, Christopher; Depew, Zachary.

In: Case Reports in Medicine, Vol. 2018, 1010678, 01.01.2018.

Research output: Contribution to journalArticle

Nayfeh, A, Kassim, T, Addasi, N, Alghoula, F, Holewinski, C & Depew, Z 2018, 'A Challenging Case of Acute Mercury Toxicity' Case Reports in Medicine, vol. 2018, 1010678. https://doi.org/10.1155/2018/1010678
Nayfeh A, Kassim T, Addasi N, Alghoula F, Holewinski C, Depew Z. A Challenging Case of Acute Mercury Toxicity. Case Reports in Medicine. 2018 Jan 1;2018. 1010678. https://doi.org/10.1155/2018/1010678
Nayfeh, Ali ; Kassim, Thamer ; Addasi, Noor ; Alghoula, Faysal ; Holewinski, Christopher ; Depew, Zachary. / A Challenging Case of Acute Mercury Toxicity. In: Case Reports in Medicine. 2018 ; Vol. 2018.
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