Total pancreatic necrosis after organophosphate intoxication

Front Med. 2019 Apr;13(2):285-288. doi: 10.1007/s11684-018-0626-z. Epub 2018 May 18.

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: insulin; organophosphate intoxication; pancreas necrosis; percutaneous catheterization; sandostatin; severe acute pancreatitis.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Anti-Bacterial Agents / therapeutic use
  • Catheterization
  • Female
  • Humans
  • Insecticides / poisoning*
  • Middle Aged
  • Organophosphate Poisoning*
  • Pancreas / diagnostic imaging
  • Pancreas / pathology*
  • Pancreatin / therapeutic use
  • Pancreatitis / chemically induced*
  • Pancreatitis / diagnostic imaging
  • Pancreatitis / therapy*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Insecticides
  • Pancreatin