A New Health Problem Due to Trichloroethylene: Pneumatosis Cystoides Intestinalis

Sato, Akio; Yamaguchi, Kotaro; Nakajima, Tamie

doi:10.1080/00039896.1987.9935812

Cited by 22 publications

(10 citation statements)

References 9 publications

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“…Fredriksson et al (1989) reported an especially high risk for colon cancer among dry cleaners exposed to TCE. Pneumocystosis of the colon, intestine, or both, might also be related to TCE exposure (Yamaguchi et al, 1985;Sata et al, 1987). In a worker population exposed to many solvents and heavy metals, Dubrow and Gute (1987) found excess stomach cancer (PMR = 174) and excess peptic ulcer (PMR = 235) in females; since death certificates were used, their limitations were noted.…”

Section: Gastrointestinal Effectsmentioning

confidence: 97%

Trichloroethylene — a Review of the Literature From a Health Effects Perspective

Gist

Burg

1995

Toxicol Ind Health

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This report reviews the literature on the impact of exposure to trichloroethylene (TCE) on human health. Special emphasis is given to the health effects reported in excess of national norms by participants in the TCE Subregistry of the Volatile Organic Compounds Registry of the National Exposure Registries--persons with documented exposure to TCE through drinking and use of contaminated water. The health effects reported in excess by some or all of the sex and age groups studied were speech and hearing impairments, effects of stroke, liver problems, anemia and other blood disorders, diabetes, kidney disease, urinary tract disorders, and skin rashes.

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Section: Gastrointestinal Effectsmentioning

confidence: 97%

Trichloroethylene — a Review of the Literature From a Health Effects Perspective

Gist

Burg

1995

Toxicol Ind Health

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“…80 Ingestion of alkyl halides as inciting agents for PI has been sup-ported by case reports and epidemiologic studies. [78][79][80][81] Metabolism of oxygen decreases gas tension in tissues. 107 Oxygen therapy has been used successfully to treat PI.…”

Section: Bacterial Gas Productionmentioning

confidence: 99%

The Spectrum of Pneumatosis Intestinalis

Peter¹

2003

Arch Surg

363

362

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A review of the spectrum of illness associated with pneumatosis intestinalis enables us to identify the probable causes of, the best diagnostic approaches to, and the most appropriate treatments for this condition. Data Sources: A review of all published material in the English language regarding pneumatosis intestinalis was conducted using the PubMed and MEDLINE databases. Any relevant work referenced in those articles and not previously found or published before the limit of the search engine was also retrieved and reviewed.Study Selection: There were no exclusion criteria for published information relevant to the topic. All of the studies cited in the present review make a point that contributes to the portrayal of this condition. In circumstances in which the same point was made in several different studies, not all were cited herein.Data Extraction: All published material on pneumatosis intestinalis was considered. Information was extracted for preferentially selected ideas and theories supported in multiple studies.Data Synthesis: The collected information was organized by theory.Conclusions: Mucosal integrity, intraluminal pressure, bacterial flora, and intraluminal gas all interact in the formation of pneumatosis intestinalis. Radiography and computed tomography are the best diagnostic tests. Nonoperative management should be pursued in most patients, and underlying illnesses should be treated. When acute complications appear, such as perforation, peritonitis, and necrotic bowel, surgery is indicated.

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“…It involved a mother, who was taking chloral hydrate, and her son, who had a psychiatric illness. There is also the hitherto unexplained epidemiological relation between exposure to trichloroethylene and PCC in Japan 31. Trichloroethylene is metabolised in the liver to trichloroethanol, the main active metabolite of chloral hydrate.…”

Section: Discussionmentioning

confidence: 99%

“…These compounds are alkyl halides like trichloroethylene and chloroform. It is relevant that trichloroethylene, which is used in the watch-making and camera industry, was recently associated with an epidemic of PCC in Japan 31. Trichloroethylene is also metabolised by the liver to trichloroethanol and trichloroacetic acid.…”

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confidence: 99%

Alkyl halides, super hydrogen production and the pathogenesis of pneumatosis cystoides coli

Florin¹

1997

Gut

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Background and aims-The colons of patients with pneumatosis cystoides coli produce excessive H 2. Exposure to alkyl halides could explain this. Six consecutive patients who had pneumatosis cystoides coli while taking chloral hydrate (1-5+ g/day) are reported. Patients 2 and 3 were investigated after they had ceased chloral hydrate treatment. One produced methane, the other did not. (Pneumatosis cystoides coli patients are non-methanogenic according to the literature.) Both had overnight fasting breath H 2 of less than 10 ppm. A literature review disclosed just one patient who was using chloral at the time of diagnosed pneumatosis cystoides coli, but an epidemic of the disease in workers exposed to trichloroethylene. Methods-(i)In vitro experiments with human faeces: chloral or closely related alkyl halides were added to anaerobic faecal cultures derived from four methaneproducing and three non-methanogenic human subjects. H 2 and CH 4 gases were measured. (ii) In vivo animal experiment: chloral hydrate was added to drinking water of four Wistar rats, and faecal H 2 compared with control rats. Results-Alkyl halides increased H 2 up to 900 times in methanogenic and 10 times in non-methanogenic faecal cultures. The K i of chloral was 0.2 mM. Methanogenesis was inhibited in concert with the increase in net H 2 . In the rat experiment, chloral hydrate increased H 2 10 times, but did not cause pneumatosis. Conclusions-Chloral and trichloroethylene are alkyl halides chemically similar to chloroform, a potent inhibitor of H 2 consumption by methanogens and acetogens. These bacteria are the most important H 2 -consuming species in the colon. It is postulated that exposure to these alkyl halides increases net H 2 production, which sets the scene for "counterperfusion supersaturation" and the formation of gas cysts. In recent times, very low prescribing rates for chloral have caused primary pneumatosis cystoides to become extremely rare. As with primary pneumatosis, secondary pneumatosis cystoides, which occurs if there is small bowel bacterial overgrowth distal to a proximally located gut obstruction, is predicted by counterperfusion supersaturation. "Inherent unsaturation" due to metabolism of O 2 is a safety factor, which could explain why gas bubbles do not form more often in tissue with high H 2 tension. (Gut 1997; 41: 778-784)

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A New Health Problem Due to Trichloroethylene: Pneumatosis Cystoides Intestinalis

Cited by 22 publications

References 9 publications

Trichloroethylene — a Review of the Literature From a Health Effects Perspective

Trichloroethylene — a Review of the Literature From a Health Effects Perspective

The Spectrum of Pneumatosis Intestinalis

Alkyl halides, super hydrogen production and the pathogenesis of pneumatosis cystoides coli

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