Fukuda Hirotsugu, Kamidani Ryo, Okada Hideshi, Kitagawa Yuichiro, Yoshida Takahiro, Yoshida Shozo, Ogura Shinji
Department of Emergency and Disaster Medicine, Gifu University Graduate School of Medicine, Gifu, 501-1194, Japan.
Abuse Prevention Center, Gifu University Graduate School of Medicine, Gifu, Japan.
Int J Emerg Med. 2022 Jul 4;15(1):31. doi: 10.1186/s12245-022-00434-4.
Benzyl alcohol is used as stripping agent in paints and other applications, and benzyl alcohol poisoning is indicated by symptoms, such as impaired consciousness, respiratory depression, hypotension, metabolic acidosis, and renal dysfunction.
A 27-year-old Asian man was transported to a hospital for severe disturbance of consciousness following exposure to a paint stripper containing benzyl alcohol, ethylene glycol, and hydrogen peroxide, which he was using to repaint a bridge. The patient was treated under sedation for benzyl alcohol poisoning. On day 3 of hospitalization, his abdominal computed tomography scan revealed a paralytic ileus, so he was transferred to our hospital. The combined toxicity from multiple substances, mainly benzyl alcohol, was thought to be a contributing factor for the paralytic ileus. Upon arrival, the patient also had chemical burns, hypernatremia, and elevated myogenic enzyme levels. His urinary hippuric acid level was high (14.9 g/L) upon admission to the previous hospital. We treated the patient with artificial respiration management, while avoiding high-density oxygen, and with gastrointestinal decompression by gastric tube implantation; laxatives were also administered. The paralytic ileus improved on the 4th day, the tube was removed on the 6th day, and the patient was discharged on the 11th day of hospitalization. No apparent complications were observed at discharge.
To the best of our knowledge, this is the first case report of paralytic ileus caused by benzyl alcohol, although multiple factors may have influenced the symptoms. After exposure to benzyl alcohol by inhalation and dermal absorption, the patient developed impaired consciousness, metabolic acidosis, and paralytic ileus, and the presence of elevated urinary hippuric acid led to a definitive diagnosis.
苯甲醇用作涂料及其他应用中的脱漆剂，苯甲醇中毒表现为意识障碍、呼吸抑制、低血压、代谢性酸中毒及肾功能障碍等症状。
一名27岁的亚洲男性在使用含苯甲醇、乙二醇和过氧化氢的脱漆剂重新粉刷桥梁后，因严重意识障碍被送往医院。该患者因苯甲醇中毒在镇静状态下接受治疗。住院第3天，其腹部计算机断层扫描显示麻痹性肠梗阻，因此被转至我院。多种物质（主要是苯甲醇）的联合毒性被认为是导致麻痹性肠梗阻的一个因素。入院时，患者还存在化学灼伤、高钠血症及肌源性酶水平升高。他在前一家医院入院时尿马尿酸水平较高（14.9 g/L）。我们对患者进行人工呼吸管理（避免高浓度氧气），并通过插入胃管进行胃肠减压；同时给予泻药。麻痹性肠梗阻在第4天有所改善，第6天拔除胃管，患者在住院第11天出院。出院时未观察到明显并发症。
据我们所知，这是首例由苯甲醇引起麻痹性肠梗阻的病例报告，尽管可能有多种因素影响了症状。患者经吸入和皮肤吸收接触苯甲醇后，出现意识障碍、代谢性酸中毒及麻痹性肠梗阻，尿马尿酸水平升高有助于明确诊断。
