Total pancreatic necrosis after organophosphate intoxication

Abstract

Cases of acute pancreatitis induced by organophosphate intoxication are encountered occasionally in clinics, but very few of them develop into severe pancreas necrosis and irreversible pancreatic function impairment. Here, we report a 47-year-old female organophosphate poisoning case after ingestion of massive insecticides; she was considered to have total necrosis and function failure of the pancreas via serum amylase test, glucose level test, and CT imaging. The patient exhibited no relief under the regular medicine treatment, which included sandostatin, antibiotics, intravenous atropine, and pralidoxime methiodide. She received percutaneous catheterization and drainage of pancreatic zone to expel hazardous necrotic waste, also by which the pathogenic evidence was obtained and the antibiotics were adjusted subsequently. The patient recovered gradually, was discharged after 2 weeks, and was prescribed with oral pancreatin capsules before meals and hypodermic insulin at meals and bedtime to compensate the impaired pancreatic function.

Keywords

organophosphate intoxication / severe acute pancreatitis / pancreas necrosis / percutaneous catheterization / sandostatin / insulin

References

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Acknowledgements

We thank Dr. Jingya Zhou from the Department of Medical Records for her kind support in the retrieval of documents.

Compliance with ethics guidelines

Rui Hou, Hongmin Zhang, Huan Chen, Yuankai Zhou, Yun Long, and Dawei Liu declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Informed consent was obtained from both the patient and her husband for which identifying information is included in this article. Other ethical board approval is not applicable in this case report.

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