Liotier Jerome, Barbier Marie, Plantefeve Gaëtan, Duale Christian, Deteix Patrice, Souweine Bertrand, Coudoré Francois
Nephrology and Reanimation, Centre Hospitalier Universitaire, Clermont-Ferrand, France.
Clin Toxicol (Phila). 2008 Nov;46(9):905-7. doi: 10.1080/15563650802269893.
The clinical signs of acute trichlorethylene overdose are commonly coma, cardiac conduction disturbances, diarrhea, and vomiting. We report a case of intentional massive trichlorethylene ingestion inducing a fatal abdominal compartment syndrome (ACS).
A 47-year-old woman was admitted to the emergency department after intentionally ingesting 500 mL of trichlorethylene and benzodiazepines. She rapidly developed coma and abdominal distension leading to multiple organ failure. Subsequent surgical evaluation revealed abdominal perforation and necrosis, and life-sustaining treatments were therefore withdrawn.
This is a primary ACS that can be explained from experimental data on the pathophysiology of pneumatosis cystoides coli. For this case, we discuss multiple etiological factors for intra-abdominal hypertension (IAP), such as paralytic ileus and massive fluid resuscitation due to the direct toxicity of ingested trichlorethylene.
Patients ingesting trichlorethylene need to be closely evaluated for risk of digestive damage and perforation. Early prompt laparotomy must be performed in cases of ACS.
急性三氯乙烯过量的临床症状通常为昏迷、心脏传导障碍、腹泻和呕吐。我们报告一例因故意大量摄入三氯乙烯导致致命性腹腔间隔室综合征（ACS）的病例。
一名47岁女性在故意摄入500毫升三氯乙烯和苯二氮卓类药物后被送入急诊科。她迅速出现昏迷和腹胀，导致多器官功能衰竭。随后的外科评估显示腹部穿孔和坏死，因此停止了维持生命的治疗。
这是一例原发性ACS，可根据结肠囊样积气病理生理学的实验数据来解释。对于该病例，我们讨论了腹内高压（IAP）的多种病因，如麻痹性肠梗阻和因摄入的三氯乙烯直接毒性导致的大量液体复苏。
摄入三氯乙烯的患者需要密切评估消化损伤和穿孔的风险。对于ACS病例，必须尽早进行剖腹探查术。
