Intraperitoneal elemental mercury exposure from a mercury-weighted bougie.
J Med Toxicol
; 9(3): 270-3, 2013 Sep.
Article
em En
| MEDLINE
| ID: mdl-23619712
ABSTRACT
INTRODUCTION:
Significant exposure to elemental mercury can occur if a mercury-weighted medical device is damaged during use. We report a case of an elemental mercury spill into the peritoneum of a patient undergoing laparoscopic gastric bypass surgery. CASE REPORT A 64-year-old man with multiple comorbidities underwent an elective Roux-en-Y gastric bypass procedure for the treatment of morbid obesity. A mercury-weighted esophageal bougie was inadvertently used during construction of the anastomosis. A suture placed through the distal tip of the device caused elemental mercury to leak into the peritoneum. Two days later, the patient underwent another surgical procedure for removal of the mercury. Intermittent air measurements taken from the laparoscope exhaust showed a peak intraperitoneal mercury concentration of 98,169 ng/m³. Blood mercury levels peaked at 146 µg/L on day 22 after the exposure, and urine mercury concentrations peaked on day 43 at 227 µg/L. The patient had no evidence of acute toxicity, but he was found to have proteinuria on follow-up evaluation.DISCUSSION:
Patients can be exposed inadvertently to toxic amounts of elemental mercury when the integrity of medical devices is compromised. We encourage hospitals to discontinue the use of devices that contain mercury. Effective alternatives that do not pose exposure risks to patients or health care workers are readily available.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Derivação Gástrica
/
Erros Médicos
/
Dilatação
/
Falha de Equipamento
/
Doença Iatrogênica
/
Complicações Intraoperatórias
/
Intoxicação por Mercúrio
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article