Özkıyım amaçlı intramuskuler Dichlorvos enjeksiyonu: Olgu sunumu

Amaç: Bu çalışmada, organofosfat içeren maddeyi özkıyım amaçlı kas içine enjekte eden bir olguyu literatür ışığında tartışmayı amaçladık. Olgu sunumu: Acil servisimize başvurmadan yaklaşık 3 saat önce özkıyım amaçlı, sol üst ekstremiteye etken maddesi Dichlorvos olan tarım ilacını kas içine enjekte eden 23 yaşındaki hastanın sol kol bölgesinde hafif eritemle beraber hassasiyet, cilt altı krepitasyon ve o bölgede ödem mevcuttu. Sistemik organofosfat zehirlenmesi belirtilerine rastlanmadığından antidot tedavisi yapılmadı. Hastanın takibinin üçüncü gününde koldaki ödem, hassasiyet ve krepitasyonda gerileme saptandı. Hastanedeki beşinci gününde tüm belirtiler ve radyolojik bulgular kayboldu. Hasta şifa ile taburcu edildi. Sonuç: Özkıyım amaçlı organofosfattın yumuşak dokulara enjeksiyonu nadirdir, fakat lokal akut inflamatuvar yanıt gibi morbiditeye neden olabileceğinden, erken dönemde düşük molekül ağırlıklı heparin, antibiyotik, analjezi ve ekstremite elevasyonu son derece önemlidir. Böyle olgularda sistemik bulgular yoksa antidot tedavisine gerek yoktur.

Intramuscular injection of Dichlorvos aimed suicide: A case report

Objective: We aimed to report a patient tried to commit suicide with Dichlorvos injection to the left arm. Case Report: A 23 year old male patient applied to our emergency department with a red inflamed injection site on the left arm. On examination it was learned that patient tried to commit suicide by injection 5 ml Dichlorvos to left forearm 3 hours ago. Patient admitted to the emergency department and arm elevated, in addition to taken low molecule height heparin, antibiotic drugs. Since we did not notice any sign of systemic organophosphate poisoning antidote therapy was not initiated. At 3rd day of observation edema, pain, subcutaneous crepitation decreased in the arm, 5th day of follow up, edema, pain, subcutaneous crepitation and radiographic sings lost. Conclusion: Suicide aimed injection of organophosphate into the soft tissue would cause acute inflammatory response, so early arm elevation and taking low molecule weighted heparin and antibiotic drugs are very important. Antidote therapy is not necessary if there is no systemic sign

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