PDF(Pubmed)
Abstract：
BACKGROUND: S-lon® (S) is a locally produced polyvinyl chloride-based solvent cement. It is a clear, slightly viscous liquid. Other constituents include 1-cyclohexanone, 3-butanone, and 1-acetone. It is used ubiquitously for building construction in Sri Lanka. Although the clinical effects of the compound have not yet been ascertained, the constituents have been implicated in neurotoxicity, respiratory tract, eye and skin irritation, and delayed liver and renal injury.
METHODS: A 42-year-old South Asian male presented following self-ingestion of S. His vital parameters were stable and initially managed symptomatically. A few hours later, he developed central nervous system depression and stridor requiring elective intubation. Examination of the upper airway revealed inflammation and edema. He was sedated and ventilated, and intravenous dexamethasone was administered. Attempts at removal of the nasogastric tube after extubation on day 3 failed. The patient had to be reintubated and sedated owing to extreme agitation not responding to routine doses of sedatives. The nasogastric tube had been amalgamated after reacting with S, forming a solid clump, later found after removal. The posterior pharynx and nasopharynx were packed and later removed before extubation. The patient made a full recovery and was transferred to the ward on day 5.
CONCLUSIONS: Ingestion of a sufficient quantity of S could result in gut absorption with central nervous system depression, coma, and even death. No antidote is available for toxicity, and management is largely supportive. As witnessed in our patient, chemical laryngitis and upper airway inflammation may lead to upper airway obstruction. Chemical reactions with medical equipment may lead to unforeseen outcomes.
METHODS: A 42-year-old South Asian male presented following self-ingestion of S. His vital parameters were stable and initially managed symptomatically. A few hours later, he developed central nervous system depression and stridor requiring elective intubation. Examination of the upper airway revealed inflammation and edema. He was sedated and ventilated, and intravenous dexamethasone was administered. Attempts at removal of the nasogastric tube after extubation on day 3 failed. The patient had to be reintubated and sedated owing to extreme agitation not responding to routine doses of sedatives. The nasogastric tube had been amalgamated after reacting with S, forming a solid clump, later found after removal. The posterior pharynx and nasopharynx were packed and later removed before extubation. The patient made a full recovery and was transferred to the ward on day 5.
CONCLUSIONS: Ingestion of a sufficient quantity of S could result in gut absorption with central nervous system depression, coma, and even death. No antidote is available for toxicity, and management is largely supportive. As witnessed in our patient, chemical laryngitis and upper airway inflammation may lead to upper airway obstruction. Chemical reactions with medical equipment may lead to unforeseen outcomes.
摘要：
背景：S-lon®（S）是一种本地生产的聚氯乙烯基溶剂水泥。这是一个明确的,略带粘性的液体。其他成分包括1-环己酮，3-丁酮,和1-丙酮。它在斯里兰卡广泛用于建筑施工。虽然该化合物的临床效果尚未确定，这些成分与神经毒性有关，呼吸道,眼睛和皮肤刺激，和迟发性肝肾损伤。
方法：一名42岁的南亚男性在自我摄入S后出现。他的生命参数稳定，最初对症管理。几个小时后,他出现了中枢神经系统抑郁和喘鸣，需要选择性插管。上呼吸道检查显示炎症和水肿。他被镇静和通风，并静脉注射地塞米松。在第3天拔管后拔除鼻胃管的尝试失败。由于极度激动，对常规剂量的镇静剂没有反应，因此不得不对患者进行重新插管和镇静。与S反应后，鼻胃管已经合并，形成一个固体团块，后来发现删除后。咽后部和鼻咽部被填充并随后在拔管前被移除。患者完全康复，并在第5天转移到病房。
结论：摄入足够量的S可导致中枢神经系统抑制的肠道吸收，昏迷,甚至死亡。没有解毒剂可用于毒性，管理层在很大程度上是支持的。正如我们的病人所见证的，化学性喉炎和上呼吸道炎症可能导致上呼吸道阻塞。与医疗设备的化学反应可能导致不可预见的结果。
方法：一名42岁的南亚男性在自我摄入S后出现。他的生命参数稳定，最初对症管理。几个小时后,他出现了中枢神经系统抑郁和喘鸣，需要选择性插管。上呼吸道检查显示炎症和水肿。他被镇静和通风，并静脉注射地塞米松。在第3天拔管后拔除鼻胃管的尝试失败。由于极度激动，对常规剂量的镇静剂没有反应，因此不得不对患者进行重新插管和镇静。与S反应后，鼻胃管已经合并，形成一个固体团块，后来发现删除后。咽后部和鼻咽部被填充并随后在拔管前被移除。患者完全康复，并在第5天转移到病房。
结论：摄入足够量的S可导致中枢神经系统抑制的肠道吸收，昏迷,甚至死亡。没有解毒剂可用于毒性，管理层在很大程度上是支持的。正如我们的病人所见证的，化学性喉炎和上呼吸道炎症可能导致上呼吸道阻塞。与医疗设备的化学反应可能导致不可预见的结果。
