Emergency Medicine, Tan Tock Seng Hospital, National Healthcare Group, Singapore.
Emergency Medicine, Tan Tock Seng Hospital, National Healthcare Group, Singapore.
J Emerg Med. 2022 Aug;63(2):e49-e52. doi: 10.1016/j.jemermed.2022.04.022. Epub 2022 Jul 22.
Bottle gourd (Lagenaria siceraria) is sometimes used in complementary medicine practice for the treatment of chronic ailments. However, there have been reports of toxicity due to consumption of bottle gourd juice, leading to severe abdominal upset and upper gastrointestinal bleeding.
We present a case of a 41-year-old gentleman who presented to the Emergency Department with multiple episodes of vomiting, hematemesis, and diarrhea after consuming bottle gourd juice. The patient was resuscitated and stabilized with fluids, proton pump inhibitors, and antiemetics. He was subsequently admitted to the General Medicine ward for further management. He continued to receive symptomatic treatment in the ward and underwent esophagogastroduodenoscopy during his hospitalization stay. His symptoms improved and he was discharged stable 5 days later. Why Should an Emergency Physician Be Aware of This? Early recognition of this rare presentation of bottle gourd toxicity is important in our local context, especially where traditional medicine is widely prevalent nowadays. Treatment is supportive. Public awareness of dangerous effects from the consumption of bitter bottle gourd juice and complementary medicine without proper consultation with a practitioner plays a crucial role to prevent further cases. Physicians need to advise patients on the use of traditional medicine and their potential side effects.
葫芦（Lagenaria siceraria）有时在补充医学实践中用于治疗慢性疾病。然而，有报道称食用葫芦汁会导致中毒，导致严重的腹部不适和上消化道出血。
我们报告了一例 41 岁男性，因饮用葫芦汁后出现多次呕吐、呕血和腹泻而到急诊科就诊。患者经补液、质子泵抑制剂和止吐药治疗后复苏并稳定。随后他被收入内科病房进行进一步治疗。他在病房继续接受对症治疗，并在住院期间进行了食管胃十二指肠镜检查。他的症状改善，5 天后稳定出院。
为什么急诊医生应该注意到这一点？在我们当地的情况下，特别是在传统医学广泛流行的今天，早期识别这种罕见的葫芦毒性表现很重要。治疗是支持性的。公众需要意识到食用苦味葫芦汁和未经适当咨询从业者而使用补充药物的危险影响，以防止进一步发生此类病例。医生需要就传统药物的使用及其潜在副作用向患者提供建议。
