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硝酸银摄入:一例病程平稳的病例报告及文献综述

Silver nitrate ingestion: report of a case with an uneventful course and review of the literature.

作者信息

Teran Carlos G, Sura Sunitha, Cabandugama Peminda, Berson Casey

机构信息

Woodhull Medical and Mental Health Center, Brooklyn; ; New York University, School of Medicine, New York, USA;

St. George's University, Grenada, West Indies.

出版信息

Clin Pract. 2011 Jul 1;1(3):e43. doi: 10.4081/cp.2011.e43.

Abstract

Silver nitrate is commonly recognized for the toxic effects followed by the direct contact with the skin and mucosa known as argyria, but there is surprisingly little information about the adverse effects of silver nitrate after ingestion. Since only a few cases were reported in the literature, the aim of this case is to enrich the little experience existent about the possible effects of silver nitrate ingestion. We describe the case of a 15-year-old female who intentionally ingested 15cc of silver nitrate solution in a suicidal attempt. The clinical picture included an excruciating burning sensation in her throat and nostrils followed by vomiting and poor oral intake. The presence of a whitish membrane on the oral and buccal mucosa without bleeding or erosions was the only remarkable finding at physical examination. Unlike the rest of the cases described in the literature the clinical and endoscopic follow up of the patient was benign and without sequela or signs of oesophageal damage. Even though very uncommon, it is very important for physicians to keep in mind the possible toxic effects and appropriate management of silver nitrate ingestion. The outcome is not always devastating as reported, and a good early approach and follow up is important in the anticipation of sequela.

摘要

硝酸银因直接接触皮肤和黏膜会产生称为银质沉着症的毒性作用而广为人知,但令人惊讶的是,关于硝酸银摄入后的不良反应的信息却很少。由于文献中仅报道了少数病例,本病例报告的目的是丰富现有的关于硝酸银摄入可能产生的影响的有限经验。我们描述了一名15岁女性的病例,她为自杀而故意摄入了15毫升硝酸银溶液。临床表现包括喉咙和鼻孔剧烈灼痛,随后出现呕吐和进食不佳。体格检查中唯一显著的发现是口腔和颊黏膜有白色膜状物,无出血或糜烂。与文献中描述的其他病例不同,该患者的临床和内镜随访结果良好,没有后遗症或食管损伤的迹象。尽管非常罕见,但医生必须牢记硝酸银摄入可能产生的毒性作用以及适当的处理方法,这一点非常重要。结果并不总是如报道的那样具有毁灭性,良好的早期处理和随访对于预防后遗症很重要。

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