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Whole bowel irrigation in an acute oral lead intoxication

  • Raymond J. Roberge
    Correspondence
    Address reprint requests to Dr Roberge, Toxicology Treatment Program, Montefiore University Hospital, 3459 Fifth Ave, Pittsburgh, PA 15213.
    Affiliations
    Toxicology Treatment Program, Montefiore University Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
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  • Thomas G. Martin
    Affiliations
    Toxicology Treatment Program, Montefiore University Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
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      Abstract

      An 89-year-old man acutely ingested approximately three ounces of a ceramic glaze preparation with a 30% lead oxide content. A blood lead level of 18 μg/mL was reported from a sample drawn within 1 hour of ingestion and just prior to gastric lavage. Following lavage, an abdominal radiograph demonstrated lead throughout the small intestine. Whole bowel irrigation was then undertaken and subsequent x-rays demonstrated clearing of all lead in the small bowel. At 16 and 24 hours post-ingestion, blood lead levels rose to 39 μg/dL and 42 μg/dL, respectively, and the patient then underwent a 5-day course of chelation therapy. This is the first reported case of the use of whole bowel irrigation in an acute lead ingestion. The use of decontamination techniques in acute lead ingestions is reviewed.

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