A case report of organophosphorus pesticide poisoning resulted in delayed severe lower intestinal hemorrhage

Tanabe, Kouichi; Ikezaki, Tomoaki; Takano, Atsuko; Suzuki, Takayuki; Kitazawa, Hdenori; Terasaki, Teiichi; Tanaka, Mai; Takeuchi, Miyako; Yamatani, Kaori; Ohkubo, Jun; Handa, Aya; Nitta, A.; Kashii, Tatsuhiko; Murakami, Nozomi

doi:10.14340/spp.2013.12c0006

Cited by 7 publications

(15 citation statements)

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“…The clinical presentation of organophosphate poisoning includes hemorrhagic ulcers of the upper gastrointestinal tract or small intestine perforations in patients . In autopsy case of organophosphate poisoning, the mucosa of both esophagus and stomach had turned brown by denaturation, and small bleeding spots were observed on the gastric mucosa .…”

Section: Resultsmentioning

confidence: 99%

Fatal Poisoning with Both Dichlorvos and Phenthoate,

Nara

Yamada

Kodama

et al. 2018

Journal of Forensic Sciences

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Organophosphates are widely used as pesticides. However, organophosphates are occasionally orally ingested to commit suicide. In this case, a man in his late 80s committed suicide by ingesting both dichlorvos and phenthoate. Autopsy findings revealed a characteristic volatile odor from his mouth, stomach, lungs, liver, and kidneys. The esophageal mucosa was denatured and had lost elasticity. Serum cholinesterase activity was 9 IU/L. Toxicological analyses performed using high-performance liquid chromatography-tandem mass spectrometry revealed that dichlorvos concentrations in the left and right cardiac blood samples were 11.6 and 4.6 μg/mL, respectively. Phenthoate concentrations in the left and right cardiac blood samples were 5.8 and 0.51 μg/mL, respectively. The total amounts of dichlorvos and phenthoate in the stomach were 7.35 and 4.55 g, respectively. The case history, autopsy findings, and toxicological analyses indicated that the cause of death was acute fatal poisoning after oral ingestion of both dichlorvos and phenthoate.

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Section: Resultsmentioning

confidence: 99%

Fatal Poisoning with Both Dichlorvos and Phenthoate,

Nara

Yamada

Kodama

et al. 2018

Journal of Forensic Sciences

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“…Besides the characteristic features, a few case reports of GI complications have been published. These are mucosal erosions, 1 gastric ulcer with perforation, 2 duodenal ulcers, 2 GI haemorrhage, 3 small intestine perforation and pancreatitis. 4 GI haemorrhage was mainly seen from secondary causes, viz.…”

Section: Discussionmentioning

confidence: 99%

“…rectal ulceration owing to repeated dosing of activated charcoal, 5 or the action of insecticide additives such as nonylphenyl ether, causing aggravated lower GI bleeding. 3 One report described upper GI bleeding and pointed it as complication of organophosphate intoxication. 2 In our case, bleeding was from an antral gastric ulcer.…”

Section: Discussionmentioning

confidence: 99%

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Massive upper gastrointestinal bleeding after organophosphate poisoning: a case report

Gupta¹,

Kumar

Agrawal³

et al. 2017

Trop Doct

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“…In humans, the inhibition of acetylcholinesterase (AChE) by OP insecticides, such as fenitrothion and malathion, causes the accumulation of acetylcholine (ACh), and leads to the overstimulation of the muscarinic receptors that induces miosis [2,4]. Although patients' pupils were miotic (1-2 mm) in clinical emergency cases of OP poisonings [5,6], in forensic autopsy cases, miosis was not always been observed owing to the elapsed time after death [7][8][9]. Conversely, the serum cholinesterase (ChE) activity markedly decreased in cases of fatal OP poisonings [7][8][9]; thus, the measurement of the deceased's serum ChE levels is used to determine the direct cause of death in acute poisoning cases caused by the ingestion of OPs [10].…”

Section: Introductionmentioning

confidence: 99%

An unusual autopsy case in which the consumption of organophosphate insecticide was not the direct cause of death

Nara¹,

Yamada²,

Suyama³

et al. 2021

Preprint

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In acute poisoning cases involving the ingestion of organophosphate insecticides such as fenitrothion and malathion, serum cholinesterase (ChE) activity is remarkably decreased, thus representing a useful indicator of the direct cause of death. In the present case, a man in his early 70s tried to committed suicide via the oral ingestion of both fenitrothion and malathion. Fenitrothion and malathion concentrations in cardiac blood were 2.63–2.98 and 0.31–0.58 µg/mL, respectively. However, the serum ChE level was 200 IU/L, which was not considerably lower than the normal range in males (242–495 IU/L). Conversely, we confirmed a positive reaction for Streptococcus pneumoniae using a urinary antigen detection kit. Moreover, histopathological analysis of both the left and right lungs revealed extensive inflammatory cell infiltration into the alveolar space. The autopsy and histopathological findings indicated that the direct cause of death was severe bacterial pneumonia caused by the infection of S. pneumoniae. This is an unusual autopsy case in which the oral ingestion of both fenitrothion and malathion was not the direct cause of the death, and might have rapidly exacerbated respiratory decline.

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A case report of organophosphorus pesticide poisoning resulted in delayed severe lower intestinal hemorrhage

Cited by 7 publications

References 0 publications

Fatal Poisoning with Both Dichlorvos and Phenthoate,

Fatal Poisoning with Both Dichlorvos and Phenthoate,

Massive upper gastrointestinal bleeding after organophosphate poisoning: a case report

An unusual autopsy case in which the consumption of organophosphate insecticide was not the direct cause of death

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