An unusual cause of recurrent abdominal pain

Krit Jongnarangsin, Sandeep Mukherjee, Michael A. Bauer

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Abdominal pain is a common complaint with diverse etiologies. We describe an unusual case of recurrent abdominal pain in an adult due to lead poisoning, a condition usually associated with childhood. A previously healthy 42-yr-old man presented with 2 days of severe crampy abdominal pain and a 1-month history of constipation. Physical examination was remarkable for diffuse abdominal pain but peritoneal signs were not present. Blood tests were remarkable for hematocrit of 33 and mean cell volume of 78, with ovalocytes and basophilic stippling on blood smear. Abdominal x-ray showed stool throughout the colon and a nonspecific bowel gas pattern. The patient was treated with intravenous fluids and enemas, and his symptoms resolved within 2 days. Repeat history taking revealed he had been stripping paint from an old Victorian house in the preceding few months. He was discharged after a blood lead level was obtained. Before his clinic appointment he was readmitted 2 days later with recurrent abdominal pain. His blood lead level was elevated at 110 μg/dl (toxic range). After consultation with the Occupational Health and Safety Administration and local poison control service, he was treated with intravenous calcium edetate disodium and intramuscular dimercaprol. He was asymptomatic at discharge, with a level of 56 μg/dl. Two weeks later, a repeat level was elevated at 72 μg/dl, for which he received a 3-wk course of oral dimercaptosuccimer. Subsequent levels were unremarkable, and the patient remains asymptomatic. Abdominal pain secondary to lead poisoning in adults is uncommon. This case highlights the importance of taking a detailed occupational history and appropriately using 'routine' blood tests to diagnose a rare condition that presented with a common complaint.

Original languageEnglish
Pages (from-to)3620-3622
Number of pages3
JournalAmerican Journal of Gastroenterology
Volume94
Issue number12
DOIs
StatePublished - 1999
Externally publishedYes

Fingerprint

Abdominal Pain
Lead Poisoning
Poisons
Hematologic Tests
United States Occupational Safety and Health Administration
Dimercaprol
Erythrocyte Indices
Paint
Enema
Constipation
Hematocrit
Edetic Acid
Physical Examination
Appointments and Schedules
Colon
Referral and Consultation
Gases
X-Rays
Lead

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

An unusual cause of recurrent abdominal pain. / Jongnarangsin, Krit; Mukherjee, Sandeep; Bauer, Michael A.

In: American Journal of Gastroenterology, Vol. 94, No. 12, 1999, p. 3620-3622.

Research output: Contribution to journalArticle

Jongnarangsin, Krit ; Mukherjee, Sandeep ; Bauer, Michael A. / An unusual cause of recurrent abdominal pain. In: American Journal of Gastroenterology. 1999 ; Vol. 94, No. 12. pp. 3620-3622.
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