Acute pancreatitis after nifedipine and acetaminophen poisoning — case report

Abstract

<jats:title>Abstract</jats:title><jats:p>The incidence of drug-induced pancreatitis is rare. There have been several reports of acute pancreatitis as a complication in acute poisoning with drugs or toxins. We present a case of a young woman with acute pancreatitis secondary to an overdose of nifedipine and acetaminophen in a suicide attempt. We excluded other causes of acute pancreatitis by clinical history, serum toxicology, serology, and abdominal imaging. The most likely underlying pathophysiological mechanism was ischemic injury of the pancreas secondary to severe collapse induced by nifedipine and possible acetaminophen-induced direct pancreatotoxicity. The pancreatitis resolved with treatment that included continuous veno-venous haemofiltration in an intensive care unit. Emergency and intensive care units should be aware of this unusual complication of such poisoning. To our knowledge, this is the first reported association between massive nifedipine overdose and acute pancreatitis.</jats:p>

Severe Intentional Corrosive (Nitric Acid) Acute Poisoning: A Case Report and Literature Review

“…The acute toxicity of nitric acid is mainly associated with the extremely corrosive nature of this strong acid. Several factors can reflect the potential toxicity of the corrosive substances and can strongly interfere with the prognosis of the patient, such as the type (acidic or alkaline agents), the pH level (<2 or >12), the volume, the concentration, the time of contact, the state of presentation (liquid substances produce more extensive injuries than solids), and the intentionality of the poisoning (suicide attempt/accidental) [5,16,21,31].…”

“…Acids will mainly affect the lower esophagus and the stomach, while alkaline chemicals will affect the oropharynx and the esophagus. One possible explanation for this could be the partial neutralizing effect that the endogenous gastric secretion might have when exposed to alkali substances [5,17,30].…”

“…Nevertheless, commercial formulations of the compound are widely accessible to the general population and are intended for household use. Most available products contain 2 of 14 approximately 56-68% nitric acid, and solutions containing 86-95% nitric acid are referred to as fuming nitric acid [1,[4][5][6].…”

“…Corrosive poisoning can induce short-term (esophageal and gastric perforation, mediastinitis, pneumomediastinum, and aspiration pneumonia) and long-term (gastro-esophageal strictures/gastric outlet obstruction, mediastinitis, esophago-respiratory fistula, malnutrition, and malignancy) complications, and proper management in both situations is essential [5,25].…”

Bulk Droplet Vitrification: An Approach to Improve Large-Scale Hepatocyte Cryopreservation Outcome

“…Many patients become too ill to tolerate liver transplantation, and even if transplantation were a viable solution, there is a severe shortage of donor organs whereby only 28% of the wait-listed patients receive transplants 1 . As bioartificial liver assist devices (BAL) enter clinical trials [2][3][4] , hepatocyte transplantation continues in clinical trials as an alternative treatment to liver failure 5 , and whole-organ tissue engineering emerges as a vertical-advancement in the field [6][7][8] , identifying suitable sources of hepatocytes is becoming an immediate issue 9 . For example, BAL devices require in the order of 10 10 hepatocytes and up to 10 9 hepatocytes are required per transplantation infusion, which must be highly viable to avoid potential harm to an already ill patient 4,10 .…”