Iberoamerican Journal of Medicine
https://iberoamjmed.com/article/doi/10.53986/ibjm.2022.0018
Iberoamerican Journal of Medicine
Case Report

A case of Aluminum Phosphide poisoning managed successfully in Nepal: A Case Report

Un caso de intoxicación por fosfuro de aluminio manejado con éxito en Nepal: informe de un caso

Suman Kumar Jha, Angela Basnet, Sabin Chaulagain, Shiva Kumar Ojha

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Abstract

Aluminum phosphide (ALP) is a highly toxic compound most commonly available as Celphos in Nepal. Suicidal ingestion is common in developing countries like Nepal as it is easily available and has a high mortality rate. Farmers to protect crops from rodents and pests use it. Here we present a case of a 24-year-old female with suicidal ingestion of one and a half-tablet of ALP presented with abdominal pain and vomiting. The patient developed metabolic acidosis, hyperkalemia, acute respiratory distress, and hypotension during the Intensive Care Unit stay. Supportive treatment with gastric lavage (coconut oil), intravenous magnesium sulfate, sodium-bicarbonate infusion, adequate vasopressor and close monitoring of hemodynamic parameters helped in the survival of the patient.

Keywords

Aluminum phosphide; Suicidal ingestion; Metabolic acidosis; Acute respiratory distress; Magnesium sulfate

Resumen

El fosfuro de aluminio (ALP) es un compuesto altamente tóxico más comúnmente disponible como Celphos en Nepal. La ingestión suicida es común en países en desarrollo como Nepal, ya que está fácilmente disponible, teniendo una alta tasa de mortalidad. Los agricultores lo utilizan para proteger los cultivos de roedores y plagas. Aquí presentamos el caso de una mujer de 24 años con ingesta suicida de una tableta y media de ALP que presentó dolor abdominal y vómitos. La paciente desarrolló acidosis metabólica, hiperpotasemia, dificultad respiratoria aguda e hipotensión durante su estancia en la Unidad de Cuidados Intensivos. El tratamiento de soporte con lavado gástrico (aceite de coco), sulfato de magnesio intravenoso, infusión de bicarbonato de sodio, vasopresor adecuado y monitoreo estrecho de los parámetros hemodinámicos ayudaron a la supervivencia del paciente.

Palabras clave

Fosfuro de aluminio; Ingesta suicida; Acidosis metabólica; Distrés respiratorio agudo; Sulfato de magnesio

References

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Submitted date:
01/28/2022

Reviewed date:
03/16/2022

Accepted date:
04/03/2022

Publication date:
04/02/2022

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