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Case Reports in Medicine
Volume 2018, Article ID 1010678, 4 pages
https://doi.org/10.1155/2018/1010678
Case Report

A Challenging Case of Acute Mercury Toxicity

1Department of Internal Medicine, Creighton University, Omaha, NE, USA
2Catholic Health Initiative (CHI), Englewood, CO, USA
3Division of Pulmonary, Critical Care, and Sleep Medicine, Creighton University, Omaha, NE, USA

Correspondence should be addressed to Zachary Depew; gro.tnegela@weped.yrahcaz

Received 16 October 2017; Accepted 14 January 2018; Published 18 February 2018

Academic Editor: Georgios D. Kotzalidis

Copyright © 2018 Ali Nayfeh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Mercury exists in multiple forms: elemental, organic, and inorganic. Its toxic manifestations depend on the type and magnitude of exposure. The role of colonoscopic decompression in acute mercury toxicity is still unclear. We present a case of acute elemental mercury toxicity secondary to mercury ingestion, which markedly improved with colonoscopic decompression. Clinical Case. A 54-year-old male presented to the ED five days after ingesting five ounces (148 cubic centimeters) of elemental mercury. Examination was only significant for a distended abdomen. Labs showed elevated serum and urine mercury levels. An abdominal radiograph showed radiopaque material throughout the colon. Succimer and laxatives were initiated. The patient had recurrent bowel movements, and serial radiographs showed interval decrease of mercury in the descending colon with interval increase in the cecum and ascending colon. Colonoscopic decompression was done successfully. The colon was evacuated, and a repeat radiograph showed decreased hyperdense material in the colon. Three months later, a repeat radiograph showed no hyperdense material in the colon. Conclusion. Ingested elemental mercury can be retained in the colon. Although there are no established guidelines for colonoscopic decompression, our patient showed significant improvement. We believe further studies on this subject are needed to guide management practices.