Use of percutaneous endoscopic gastrostomy tube as a conduit for endoscopic retrieval of accidentally ingested mercury

摘要

A 42-year-old male presented to the emergency surgery room (ESR) with complaint of accidental mercury ingestion. As recorded by a glass mercury thermometer, the patient was febrile for 3 days before admission. He had a history of stroke 6 months prior, the sequelae of which, a sudden spastic attack, resulted in accidental chewing of the thermometer. The patient also had an indwelling percutaneous endoscopic gastrostomy (PEG) for,severe dysphagia post the episode of stroke. On examination, the patient was conscious and alert. He was given a gentle head-low position, and X-ray of the chest and abdomen was done to confirm the diagnosis. In view of the diagnosis, the patient was taken up for an emergency upper gastrointestinal (GI) tract endoscopy to retrieve the mercury and prevent its systemic absorption and toxicity. The procedure was done under total intravenous anesthesia (TIVA).