Anesthesia in Patient with Lead Poisoning: Case Report

Lima, Luís Mauro Alvim de; Resende, Flávio Castro; Santos, Ana Carolina Janiques dos; Terra, Patricia Pimentel Duarte Rodrigues; Pantoja, Alberto Vieira; Resende, Marco Antonio Cardoso de

doi:10.1016/s0034-7094(12)70186-1

Cited by 3 publications

(1 citation statement)

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“…As of 2004, fewer than 100 cases of Pb toxicity caused by retained bullets had been reported in the medical literature 10 11. However, in the USA during 2003–2012, a total of 457 cases of BLLs ≥10 µg/dL in patients with retained bullets were identified by the Adult Blood Lead Epidemiology Surveillance (ABLES) programme 12.…”

Section: Discussionmentioning

confidence: 99%

Severe lead toxicity attributed to bullet fragments retained in soft tissue

Weiss¹,

Lee

Feldman

et al. 2017

BMJ Case Reports

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A man aged 30 years presented to an emergency department with a 1 month history of severe abdominal pain, jaundice, constipation, lower extremity weakness and weight loss. A peripheral blood smear was performed that showed basophilic stippling of erythrocytes prompting a blood lead level (BLL) evaluation. The patient had a BLL of >200 µg/dL. Retained bullet fragments were identified in the left lower extremity from a previous gunshot wound 10 years prior. Lead from the excised bullet fragment was consistent with the patient's blood lead by isotope ratio analysis. This case is a rare example of a severely elevated BLL attributed to bullet fragments in soft tissue. Bullets retained in soft tissue are not often considered a risk factor for a markedly elevated BLL because they become encapsulated within the tissue over time.

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Section: Discussionmentioning

confidence: 99%