Citation

Rusyniak DE, Nanagas KA. Clin. Toxicol. (Phila) 2008; 46(9): 831-833.

Copyright

(Copyright © 2008, Informa - Taylor and Francis Group)

DOI

10.1080/15563650701846288

PMID

18608269

Abstract

INTRODUCTION: Few cases of mercury sequestration in the appendix appear in the literature. Based on these, both prophylactic appendectomy and non-surgical management have been recommended. We report a case in which a patient with mercury retained in the appendix was managed conservatively without developing mercurialism or appendicitis.
CASE REPORT: A 43-year-old man ingested approximately one tablespoon of elemental mercury after an argument with his wife. An initial abdominal radiograph showed mercury in the pylorus of the stomach and a follow-up x-ray at 72 hours showed mercury localized to the appendix. The patient was treated as an outpatient and examined several times over a 37-day period. He never developed signs of appendicitis. On a follow-up examination 7 months after the ingestion, he was radiographically free of mercury. Periodically throughout his clinical course, blood mercury levels were obtained. Only one, 6 days after ingestion, showed an elevated mercury level of 68 mcg/L (reference range <10 mcg/L). Despite this, the patient never developed signs or symptoms of mercury poisoning.
CONCLUSION: Patients in whom elemental mercury is retained in the appendix, who are without symptoms and have normal gastric mucosa, may be conservatively managed without surgery.

Language: en

Keywords

Adult; Ambulatory Care; Appendix; Follow-Up Studies; Humans; Male; Mercury; Mercury Poisoning; Pylorus; Radiography, Abdominal; Suicide, Attempted