Liposuction Technique Used as a Treatment Modality for Suicide Attempt by Injection of Mercury

Abstract

Elemental mercury poisoning commonly occurs through vapour inhalation as it is well absorbed through the lungs. Administering subcutaneous and intravenous elemental mercury is very uncommon with only a few isolated case reports in literature. We present a case of attempted suicide by subcutaneous injection of elemental mercury, an unusual substance used for suicide. As the attempt at self-injury was not confessed by the patient, diagnosis was challenging. Patient was treated with an initial diagnosis of cellulitis, but with repeated and persistent questioning, a history of selfinjection of mercury into the arm was revealed. On confirmation, mercury was aspirated from subcutaneous space similar to liposuction technique under X-ray guidance. Management of subcutaneous injection of elemental mercury with particular emphasis on the need for surgical removal of all available mercury is discussed.

Factitial panniculitis secondary to injected subcutaneous elemental mercury

“… 2 , 4 , 7 Less common presentations, such as nonhealing ulcer, sterile abscess, and cellulitis-like and morbilliform rash, have also been reported. 5 , 6 , 8 Most self-injections are in multiple locations in accessible areas. 2 , 4 , 5 , 6 To our knowledge, symmetric and panniculitis-like presentation of self-injected mercury has not been previously reported.…”

“… 6 However, mercury levels in the blood and urine can be elevated, mandating chelation therapy with dimercaptosuccinic acid, dimercaprol, or D-penicillamine. 5 , 6 , 7 , 8 The management of subcutaneous elemental mercury includes debridement of tissues with mercury, monitoring of systemic manifestations of toxicity, chelation therapy in symptomatic cases or cases with elevated blood mercury levels, and psychiatric evaluation of the patient.…”

Can Liposuction Technique Be Used as a Treatment Method in Cases of Mercury Injections?

“…Sir, We read the case report titled BLiposuction technique used as a treatment modality for suicide attempt by injection of mercury^published in your reputed journal [1] with lots of interest. We congratulate the authors Sai Suraj Kotera and his team for reporting an interesting and innovative idea of the application of liposuction in mercury poisoning.…”