RESUMO
Ingestion of a foreign body containing lead in children carries the additional risk of acute lead poisoning secondary to dissolution and absorption of the ingested lead in the acid environment of the stomach. We report the case of a 3-year-old girl who ingested a lead sinker. The patient was asymptomatic but therapy with a proton pump inhibitor (omeprazole) was empirically started on admission and the foreign body was removed from the stomach by emergency endoscopy within 6 hours of ingestion. Despite the quick removal, blood lead levels (drawn 3 hours after ingestion) exceeded 40 .g/dl. The patient completely recovered and continues to do well after 1 year of follow-up. This case reveals that acute elevations of blood lead concentrations may occur rapidly after ingestion of lead foreign bodies. Even in the absence of symptoms, lead foreign body ingestion in children should prompt lead screening and initiation of appropriate treatment.
Assuntos
Deglutição , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/cirurgia , Intoxicação por Chumbo , Doença Aguda , Pré-Escolar , Feminino , Humanos , RadiografiaRESUMO
La ingestión de cuerpos extraños de contenido plúmbico tiene el riesgo adicional de ocasionar una intoxicación aguda por plomo secundaria a la disolución y absorción del plomo ingerido en el ambiente ácido del estómago. Se presenta el caso de una niña de 3 años que ingirió una plomada de pesca. La paciente estaba asintomática, pero se inició tratamiento empírico con un inhibidor de bomba de protones (omeprazol) a su llegada a urgencias y el cuerpo extraño se extrajo urgentemente mediante endoscopia a las 6 h de su ingestión. A pesar de la rápida actuación, los valores de plomo en sangre (obtenidos a las 3 h de la ingesta) excedieron los 40 μg/dl. La paciente se recuperó por completo y continúa sana tras un año de seguimiento. Este caso revela que tras la ingesta de cuerpos extraños plúmbicos se puede producir una elevación rápida de los valores de plomo en sangre. Incluso en ausencia de síntomas, ante la ingestión de cuerpos extraños con contenido plúmbico en pacientes pediátricos, debe evaluarse el nivel de plomo en sangre e instaurarse tratamiento adecuado
Ingestion of a foreign body containing lead in children carries the additional risk of acute lead poisoning secondary to dissolution and absorption of the ingested lead in the acid environment of the stomach. We report the case of a 3-year-old girl who ingested a lead sinker. The patient was asymptomatic but therapy with a proton pump inhibitor (omeprazole) was empirically started on admission and the foreign body was removed from the stomach by emergency endoscopy within 6 hours of ingestion. Despite the quick removal, blood lead levels (drawn 3 hours after ingestion) exceeded 40 μg/dl. The patient completely recovered and continues to do well after 1 year of follow-up. This case reveals that acute elevations of blood lead concentrations may occur rapidly after ingestion of lead foreign bodies. Even in the absence of symptoms, lead foreign body ingestion in children should prompt lead screening and initiation of appropriate treatment
