Leong Waiian, Li Chunlian, Long Yuhui, Wang Yanli, Wai Abraham Kc, Huang Yi, Lau Feilung
Department of Accident & Emergency, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
Department of Emergency Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
SAGE Open Med Case Rep. 2025 Jan 4;13:2050313X241311316. doi: 10.1177/2050313X241311316. eCollection 2025.
Acute barium poisoning is a rare but life-threatening method of suicide attempt, and it is a challenging disease in the emergency department. We report a case of barium carbonate poisoning in a 21-year-old man who ingested a large dose to attempt suicide and presented with gastrointestinal symptoms, gradual muscular weakness, and severe hypokalemia (K1.63 mmol/L). He was promptly managed with gastric lavage, respiratory support, and large doses of oral and intravenous potassium supplementation. In addition, intravenous sodium thiosulfate and continuous venovenous hemodiafiltration were administered to reduce the serum concentration of barium ions. Following comprehensive treatment, the patient recovered within 5 days and discharged home for 12 days. Clinicians should be vigilant when a patient presents gastrointestinal symptoms and limb weakness, associated with severe hypokalemia and cardiac arrhythmia over a short disease course as these may indicate potential barium poisoning. Furthermore, we advocate for paying more attention to the management of toxic substances and the mental health education of young adults.
急性钡中毒是一种罕见但危及生命的自杀方式，在急诊科是一种具有挑战性的疾病。我们报告一例21岁男性碳酸钡中毒病例，该患者摄入大量碳酸钡企图自杀，出现胃肠道症状、渐进性肌肉无力和严重低钾血症（血钾1.63 mmol/L）。他立即接受了洗胃、呼吸支持以及大剂量口服和静脉补钾治疗。此外，还给予静脉注射硫代硫酸钠和持续静脉血液透析滤过以降低血清钡离子浓度。经过综合治疗，患者在5天内康复，并于12天后出院。当患者在短病程内出现胃肠道症状和肢体无力，并伴有严重低钾血症和心律失常时，临床医生应保持警惕，因为这些可能提示潜在的钡中毒。此外，我们主张更加关注有毒物质的管理以及对年轻人的心理健康教育。
