Ischemia Complications After Calcium Channel Blocker Poisoning

La lesión vascular colónica secundaria a la sobredosis de verapamilo, es mediada por radicales libres, formando microtrombos vasculares y generación de endotoxinas, siendo un diagnostico difícil. Caso Clínico: Femenino de 27 años, ingresa con abdomen agudo de 4 días posteriores a un evento remitido de intento suicida por sobredosis de verapamilo, interviniéndose quirúrgicamente donde se halla necrosis colónica transmural derecha, realizando hemicolectomía derecha con ileostomía terminal. Conclusiones: Reconocer y tratar de forma adecuada un abdomen agudo, no siempre se suele llegar a un adecuado diagnostico, por lo cual una minuciosa anamnesis lograría concluirlo.

show abstract

“…Entre los hallazgos transquirúrgicos por medio de laparotomías se han descrito infartos intestinales extensos, con predominio de colon 4 .…”

Section: Discussionunclassified

“…La isquemia intestinal secundaria a intoxicación por verapamilo se presenta a dosis > 0.5-1 mg/kg/dosis 4,5 . Debido a su propensión por la arteria mesentérica superior, sobre todo por su primera rama (cólica derecha), la intoxicación con verapamilo predispone al desarrollo de isquemia-necrosis del hemicolon derecho 5 .…”

Section: Introductionunclassified

Necrosis colónica secundaria. Informe de caso

Aburto-Fernández¹,

Araujo-López²,

García-Godoy³

et al. 2019

CIRU

View full text Add to dashboard Cite

show abstract

“…Above, we described case reports of cerebral infarction following CCB overdose. Other case reports and retrospective analyses have described bowel ischemia and renal ischemia due to high-dose vasopressor use in the setting of CCB overdose [ 47 , 48 ].…”

Section: Discussionmentioning

confidence: 99%

Bilateral blindness secondary to optic nerve ischemia from severe amlodipine overdose: a case report

et al. 2017

View full text Add to dashboard Cite

BackgroundCalcium channel blockers are commonly prescribed medications; calcium channel blocker overdose is becoming increasingly prevalent. The typical presentation of a calcium channel blocker overdose is hypotension and decreased level of consciousness. We describe a case of a calcium channel blocker overdose that led to bilateral cortical blindness, a presentation that has not previously been reported.Case presentationA 49-year-old white woman with known bilateral early optic atrophy presented to our hospital with hypotension and obtundation following a known ingestion of 150 mg of amlodipine. She was transferred to our intensive care unit where she was intubated, mechanically ventilated, and required maximal vasopressor support (norepinephrine 40 mcg/minute, epinephrine 40 mcg/minute, and vasopressin 2.4 units/hour) along with intravenously administered crystalloid boluses. Despite these measures, she continued to deteriorate with persistent hypotension and tachycardia, as well as anuria.Intralipid emulsion therapy was subsequently administered to which no initial response was observed. A chest X-ray revealed diffuse pulmonary edema; intravenous diuresis as well as continuous renal replacement therapy was initiated.Following the initiation of continuous renal replacement therapy, her oxygen requirements as well as urine output began to improve, and 3 days later she was liberated from mechanical ventilation. Following extubation, she complained of new onset visual impairment, specifically seeing only red-green colors, but no objects. An ophthalmologic examination revealed that this was due to bilateral optic atrophy from prolonged hypotension during the first 24 hours after the overdose.ConclusionPersistent hypotension in the setting of a calcium channel blocker overdose can lead to worsening optic atrophy resulting in bilateral cortical blindness.

show abstract