Multiple organ dysfunction syndrome caused by fish gallbladder poisoning: A case report of delayed etiological diagnosis

Abstract

Rationale: Fish gallbladder poisoning is an acute poisoning caused by eating fish gallbladders, which can damage the functions of multiple organs such as the heart, liver, and kidneys, and can be fatal in severe cases.

Patient concerns: A 56-year-old female farmer, believing in a folk remedy, consumed the gallbladder of a black carp (Mylopharyngodon piceus) weighing approximately 4 kg to treat her cough. She subsequently developed abdominal pain and diarrhea for 6 days, followed by 1 day of anuria.

Diagnoses: Fish gallbladder poisoning and multiple organ dysfunction syndrome.

Interventions: The patient underwent oxygen therapy, anti-infective treatment, hepatoprotective measures, acid suppression and gastric protection, anti-heart failure management, correction of anemia, maintenance hemodialysis, and symptomatic and supportive care.

Outcomes: After nearly 2 weeks of hospitalization, the patient's condition improved. Following discharge, she continued maintenance hemodialysis for approximately 3 months, until her renal function was restored.

Lessons: Fish gallbladder poisoning is primarily caused by toxins such as histamine, hydrocyanic acid, and cyprinol sulfate, leading to severe multiorgan dysfunction, particularly acute kidney injury. Early recognition, prompt hemodialysis, and comprehensive supportive treatment are essential for a favorable prognosis. Maintaining clinical vigilance and providing public health education on the dangers of consuming fish gallbladders are crucial for preventing similar incidents.

Keywords: case report; delayed diagnosis of the cause; fish gallbladder poisoning; multiple organ dysfunction syndrome; murtagh safe diagnosis and treatment.