A Case of Abdominal Compartment Syndrome and Necrosis of Entire Small Intestine Caused by Ingested Potassium Carbonate

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  • 炭酸カリウム服用によりＡｂｄｏｍｉｎａｌ　Ｃｏｍｐａｒｔｍｅｎｔ　Ｓｙｎｄｒｏｍｅと全小腸壊死に至った１例

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A 52-year-old man was admitted 1 hour after he had ingested 300 ml of a strong alkaline developing solution consisting mainly of potassium carbonate. On admission, he complained of abdominal pain and nausea. The gastrointestinal endoscopy revealed hemorrhagic erosion and mucosal necrosis of the esophagus, stomach and duodenum. Ventricular fibrillation occurred transiently attributable to hyperkalemia due to absorption of potassium. On the third hospital day, abdominal compartment syndrome (ACS) caused by intestinal edema developed. Decompression laparotomy was performed, and 170 cm of completely necrosed small intestine was removed. The second look operation was performed on the 13th hospital day. Since multiple necrosis and perforations were observed over the stomach, total gastrectomy and reconstruction were performed. Although the patient subsequently underwent multi-disciplinary treatment, necrosis of the entire intestinal tract occurred, and the patient died on the 26th hosipital day. There is only a report of poisoning by consumption of potassium carbonate. In our case, necrosis to the serous membrane of the stomach and small intestine occurred in a short period of time. Consumption of a large volume of strong alkali requires appropriate management while paying attention to not only the upper digestive tract, but also small intestine, including the occurrence of ACS.

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