Atluri Paavani, Vasireddy Deepa, Malayala Srikrishna V
Internal Medicine, Bay Area Hospital, Coos Bay, USA.
Pediatrics, Pediatric Group of Acadiana, Lafayette, USA.
Cureus. 2021 Feb 3;13(2):e13092. doi: 10.7759/cureus.13092.
Toxic alcohol ingestion can be fatal or produce irreversible tissue damage and hence timely recognition and treatment are very important. The physician has to often rely on clinical features and different lab values in order to derive the possible causative agent consumed. Gas chromatography is the definitive diagnostic test to detect the toxic alcohol but is unfortunately not available to run in house in most hospital laboratories in the acute clinical setting. We present a 41-year-old gentleman who was brought to the ED for further evaluation of vomiting and upper abdominal pain. Our clinical impression was that the patient had possible mixed toxic alcohol ingestion. General principles and treatment of alcohol intoxication include gastric lavage or use of activated charcoal. Administration of ethanol or fomepizole to delay or prevent generation of toxic metabolites needs to be initiated while sufficient alcohol remains and metabolized and measurement of blood alcohol concentrations and/or serum osmolality can be helpful. Dialysis is helpful in removing unmetabolized alcohol and possibly toxic metabolites and delivering base to patients to ameliorate metabolic acidosis.
摄入有毒酒精可能会致命或导致不可逆的组织损伤，因此及时识别和治疗非常重要。医生常常需要依靠临床特征和不同的实验室检查结果来确定可能摄入的致病物质。气相色谱法是检测有毒酒精的确诊性诊断测试，但不幸的是，在急性临床环境中，大多数医院实验室无法在内部进行此项检测。我们报告一名41岁男性，因呕吐和上腹部疼痛被送至急诊科进一步评估。我们的临床印象是该患者可能混合摄入了有毒酒精。酒精中毒的一般治疗原则包括洗胃或使用活性炭。在体内仍有足够的酒精可供代谢时，应开始给予乙醇或甲吡唑以延迟或防止有毒代谢产物的生成，测量血液酒精浓度和/或血清渗透压可能会有所帮助。透析有助于清除未代谢的酒精和可能的有毒代谢产物，并为患者补充碱以改善代谢性酸中毒。
