Abstract:
A 40-year-old woman was admitted to our hospital by ambulance due to accidental ingestion of 100ml of 35% hydrogen peroxide. Although the patient suffered from frequent vomiting, abdominal distension, and abdominal pain, signs of peritonitis were not observed. An abdominal computed tomography examination demonstrated obvious gas images in the gastric wall and intrahepatic portal veins. Upper gastrointestinal endoscopy revealed mucosal redness, swelling, and erosion from the lower part of the esophagus to the duodenum. Portal venous gas and upper gastrointestinal mucosal injury due to accidental hydrogen peroxide ingestion were suspected. As the vital signs were stable and there were no signs peritoneal irritation or neurological symptoms, she was treated medically with vonoprazan, rebamipide, and sodium alginate. The next day, abdominal symptoms immediately improved and 3 days later, hepatic portal venous gas had disappeared on ultrasonography. She was discharged on the 5th day after admission. Two months later, upper gastrointestinal endoscopy showed improvement in inflammatory findings. We report a remarkable case of hepatic portal venous gas and upper gastrointestinal mucosal injury and elucidate the endoscopic findings associated with hydrogen peroxide ingestion.
摘要:
由于意外摄入100毫升35%的过氧化氢,一名40岁的妇女被救护车送往我们医院。虽然病人经常呕吐,腹胀,还有腹痛,没有观察到腹膜炎的迹象。腹部计算机断层扫描检查显示胃壁和肝内门静脉中明显的气体图像。上消化道内镜显示粘膜发红,肿胀,从食道下部到十二指肠的侵蚀。怀疑由于意外摄入过氧化氢引起的门静脉气体和上消化道粘膜损伤。由于生命体征稳定,没有腹膜刺激或神经症状的迹象,她接受了vonoprazan的药物治疗,瑞巴派特,和海藻酸钠。第二天,腹部症状立即好转,3天后,肝门静脉气体在超声检查中消失。她在入院后第5天出院。两个月后,上消化道内镜显示炎症反应改善.我们报告了一例肝门静脉气体和上消化道粘膜损伤的显着病例,并阐明了与过氧化氢摄入相关的内窥镜检查结果。