Abstract
A 19-year-old woman underwent multiple attempts at orogastric lavage before success
5 h after ingesting approximately 24 grams of ibuprofen in a suicide attempt. Activated
charcoal was administered via the lavage tube. She vomited charcoal shortly after
administration and began experiencing difficulty breathing and an increase in the
pitch of her voice. A chest X-ray study showed a widened mediastinum, pneumopericardium,
and subcutaneous emphysema consistent with esophageal perforation that was confirmed
by computed tomography scan. Surgical exploration revealed a tear in the proximal
posterior esophagus with charcoal in the posterior mediastinum. She remained intubated
for 7 days and was discharged 14 days after admission. This is a report of esophageal
perforation with activated charcoal contamination of the mediastinum after gastric
lavage. The risks and benefits of this procedure should be carefully considered in
each patient prior to its use. Awake patients should be cooperative with the procedure
to minimize any risk of trauma to the oropharynx or esophagus.
Keywords
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Article info
Publication history
Accepted:
October 30,
2000
Received in revised form:
October 13,
2000
Received:
February 8,
2000
Identification
Copyright
© 2001 Elsevier Science Inc. Published by Elsevier Inc. All rights reserved.
