Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal.
Lumbini Medical College, Tansen, Palpa, Nepal.
JNMA J Nepal Med Assoc. 2024 Jul 31;62(276):548-551. doi: 10.31729/jnma.8699.
Herbicide such as 2,4-Dichlorophenoxyacetic acid is commonly used in wheat growing regions and is being ingested with suicidal intent due to easy availability and lack of regulation for buying it. Various articles suggest high fatality upon ingestion of this compound. We report a rare survival of a 24-year-old male who ingested about 45 ml of the compound and presented with symptoms similar to organophosphate poisoning. Before presenting to our hospital, the patient was misdiagnosed and an atropine challenge test and gastric lavage was done. However, after presenting to our center, detailed history was taken and the bottle containing the compound was retrieved, following which the patient was shifted to the intensive care unit where urinary alkalinization and forced diuresis was done. He started getting better and was discharged on fourth day. Detailed history taking can prevent misdiagnosis of 2,4-Dichlorophenoxyacetic acid poisoning. Early diagnosis and adequate supportive management of urinary alkalinization and forced diuresis can improve patient outcomes and reduce fatality.
除草剂如 2,4-二氯苯氧乙酸在小麦种植区被广泛使用，由于其易于获得且购买不受监管，有人故意摄入该物质来自杀。各种文章表明，摄入这种化合物后死亡率很高。我们报告了一例罕见的存活病例，一名 24 岁男性摄入了约 45 毫升该化合物，出现了类似有机磷中毒的症状。在被送到我们医院之前，该患者被误诊，并进行了阿托品挑战试验和洗胃。然而，在被送到我们中心后，详细询问了病史并找到了装有该化合物的瓶子，随后将患者转至重症监护病房，进行尿液碱化和强制利尿。他开始好转，并在第四天出院。详细询问病史可以防止对 2,4-二氯苯氧乙酸中毒的误诊。早期诊断和充分的支持性治疗，包括尿液碱化和强制利尿，可以改善患者的预后并降低死亡率。
