[Severe potassium dichromate poisoning after accidental nasal introduction]. / Intoxication grave au dichromate de potassium après introduction nasale accidentelle.

BACKGROUND: Nasal foreign body (NFB) is a common situation in pediatrics. Poisoning is a rare complication of NFB insertion. We report a case of acute potassium dichromate poisoning secondary to NFB insertion. CASE REPORT: Six days after insertion of a NFB, progressive occurrence of diarrhea, vomiting, nasal obstruction, acute renal failure, pancreatitis, hepatitis and drowsiness justified hospitalization of a 3-year-old girl in the pediatric intensive care unit. Acute potassium dichromate poisoning was confirmed by high plasma chromium level and by the spectrophotometric analysis of the crystal. Recovery was satisfactory with supportive treatment. An official survey allowed to discover that the crystal was freely sold and that its toxicity was unknown by dealers, while no information was given to the customers. CONCLUSION: Transmucosal absorption of toxics is an unusual severe potential hazard that should be evoked to allow a rapid management. After the discovery and withdrawal of a NFB, occurrence of systemic symptoms, even trivial, must make one suspect a poisoning. In this circumstance, analysis of the foreign body should be done, associated with toxicologic dosages. This case report illustrates that potassium dichromate poisoning is a severe medical condition and that its clinical presentation assume a large widespread of symptoms due to multiple organ involvement.

[Nasal polyposis in children. Diagnostic and therapeutic problems]. / La polypose naso-sinusienne de l'enfant. Diagnostic et problèmes thérapeutiques.

Nasal polyposis in an infrequent condition in children and may occur as part of a variety of diseases. Treatment is difficult and often yields disappointing results. The purpose of this paper is to review the diagnostic problems raised by nasal polyposis and to analyze current surgical approaches. Twenty-seven patients with a mean age of 12 years, including 12 with nasal polyposis as part of another disease state (cystic fibrosis in 10 and Woakes disease in 2) and 15 with idiopathic nasal polyposis, underwent endonasal ethmoidectomy. The decision to perform this procedure was based on severity of initial clinical symptoms, lack of improvement under medical treatment, and availability for close postoperative follow-up. Twenty-six patients were followed-up for a mean period of three years ad a half. Complete recurrence occurred in 15% of patients and partial recurrence in 8%. In all the other cases, the ethmoidal cavity was satisfactory and nasal symptoms resolved completely. Etiopathogenic aspects of nasal polyposis are reviewed, as well as the therapeutic approach according to whether or not the disease occurs as part of another syndrome.