Document Detail


Intestinal pseudo-obstruction (Ogilvie's syndrome) in theophylline overdose.
MedLine Citation:
PMID:  8888546     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Intestinal pseudo-obstruction (Ogilvie's syndrome) has previously been reported in 2 patients with theophylline toxicity treated with activated charcoal (AC), mechanical ventilation and opioid induced sedation. We report a case of Ogilvie's syndrome in a theophylline toxic patient treated with AC. A 45-y-old male with severe chronic obstructive pulmonary disease presented with vomiting and multifocal atrial tachycardia after an intentional theophylline overdose. His initial potassium concentration was 2.7 mEq/L and his theophylline was 191 mg/L (1060 mumol/L). The patient was hemodialyzed and given a total of 1,000 g of AC without cathartics during the first hospital day. He also received iv potassium replacement. On the second hospital day he required mechanical ventilation for respiratory acidosis. Clindamycin was given for purulent sputum and fever. Haloperidol was given to treat agitation. No other anticholinergic agents or opioids were given. The patient's potassium rose to 6.5 mEq/L and he was given kayexalate. During the third hospital day the patient developed abdominal distention, tenderness and leukocytosis. Abdominal radiographs revealed a distended cecum. In the operating room the cecum was found dilated to 16 cm with no distal obstruction. A cecostomy tube drained AC and pill fragments. A 6 cm charcoal bezoar was found in the stomach. The patient recovered uneventfully.
Authors:
J R Brubacher; B Levine; R S Hoffman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Veterinary and human toxicology     Volume:  38     ISSN:  0145-6296     ISO Abbreviation:  Vet Hum Toxicol     Publication Date:  1996 Oct 
Date Detail:
Created Date:  1997-01-21     Completed Date:  1997-01-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7704194     Medline TA:  Vet Hum Toxicol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  368-70     Citation Subset:  IM    
Affiliation:
New York Poison Control Center, NY 10016, USA.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Anti-Bacterial Agents / administration & dosage,  therapeutic use
Antidotes / administration & dosage,  therapeutic use*
Charcoal / administration & dosage,  therapeutic use*
Clindamycin / administration & dosage,  therapeutic use
Colonic Pseudo-Obstruction / chemically induced,  drug therapy*,  therapy
Combined Modality Therapy
Female
Humans
Injections, Intravenous
Intensive Care Units
Male
Middle Aged
Overdose
Potassium / administration & dosage,  blood,  therapeutic use
Renal Dialysis
Respiration, Artificial
Theophylline / administration & dosage,  adverse effects*,  blood
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Antidotes; 16291-96-6/Charcoal; 18323-44-9/Clindamycin; 58-55-9/Theophylline; 7440-09-7/Potassium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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