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Intestinal Obstruction Due to Mercury Granuloma

Intestinal Obstruction Due to Mercury Granuloma Abstract METALLICmercury, generally regarded as inert, is known to stimulate the formation of granulomatous lesions.1 We have recently treated a patient in whom intestinal obstruction was caused by mercury granulomas. It is clear from our experience and from a review of the literature that rupture of the mercury-filled balloon fixed to the end of a long intestinal tube may lead to serious complications. In this communication, we list practices which we now follow in such cases. Report of a Case A 68-year-old man was admitted to the hospital with symptoms and physical signs of intestinal obstruction. The diagnosis was confirmed by roentgenograms. Three years before, the patient had had sigmoid colectomy for chronic volvulus. Two months later, he had mechanical intestinal obstruction, which, during a 48-hour trial, failed to respond to intestinal decompression with a Miller-Abbott tube. Abdominal exploration was required for enterolysis. Two enterotomies had to be done to decompress References 1. Crikelair, G.F., and Hiratzka, T.: Intraperitoneal Mercury Granuloma , Ann Surg 137:494-496 ( (Oct) ) 1953.Crossref 2. Siversten, cited by Wangensteen, O.H.: Intestinal Obstructions , ed 3, Springfield, Ill: Charles C Thomas, Publisher, 1955, p 232. 3. Harris, F.I.: A New Rapid Method of Intubation With the Miller-Abbott Tube , JAMA 125:784-785 ( (July 15) ) 1944.Crossref 4. Wild, J.J.: Apparatus for Intestinal Intubation , Brit Med J 6:815-816 ( (June) ) 1944. 5. Cantor, M.O.: Mercury Lost in the Gastrointestinal Tract , JAMA 146:560-561 ( (June 9) ) 1951.Crossref 6. Hoffman, I.L.: Spontaneous Evacuation of Metallic Mercury From the Vermiform Appendix , Bull US Army Med Dept 8:802-803 ( (Oct) ) 1948. 7. Birnbaum, W.: Inflammation of the Vermiform Appendix by Metallic Mercury , Amer J Surg 74:494-496 ( (Oct) ) 1947.Crossref 8. Kristoffersen, K.: Metallic Mercury as the Cause of Intestinal Ulceration , Nord Med 62:1388-1389 ( (Sept) ) 1959. 9. Bradford, F.E.; Hugo, G.J.; and Quinn, W.F.: Persistent Rectal Fistula Due to Metallic Mercury , Amer J Surg 93:74-76 ( (Jan) ) 1957.Crossref 10. Lindenmuth, W.W.: Fecal Fistula Due to Metallic Mercury From a Miller-Abbott Tube , JAMA 141:986-987 ( (Dec 3) ) 1949.Crossref 11. Hanselman, R.C., and Meyer, R.H.: Complications of Gastrointestinal Intubation , Int Abstr Surg 114:207-208 ( (June) ) 1962. 12. Farrell, J.J., and Reams, G.B.: Abuse of Intestinal Intubation , Amer Surg 23:401-408 ( (May) ) 1957. 13. Vare, V.B., Jr.: Extravasated Metallic Mercury Simulating Osteomyelitis , US Armed Forces Med J 4:773-775 ( (May) ) 1953. 14. Cantor, M.O.: Intestinal Intubation , Springfield, Ill: Charles C Thomas, Publisher, 1949, p 279. 15. Leonard, A.S., et al: Intestinal Decompression: Use of a Long Tube With a Coiled Spring Which Achieves Relief on Distension Without Enterotomy or Enterostomy , Surgery 49:440-449 ( (April) ) 1961. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Intestinal Obstruction Due to Mercury Granuloma

Lindsey, Edward S.; Becker, Walter F.
Archives of Surgery , Volume 97 (4) – Oct 1, 1968
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References (17)

Publisher
American Medical Association
Copyright
Copyright © 1968 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1968.01340040064010
Publisher site
See Article on Publisher Site

Abstract

Abstract METALLICmercury, generally regarded as inert, is known to stimulate the formation of granulomatous lesions.1 We have recently treated a patient in whom intestinal obstruction was caused by mercury granulomas. It is clear from our experience and from a review of the literature that rupture of the mercury-filled balloon fixed to the end of a long intestinal tube may lead to serious complications. In this communication, we list practices which we now follow in such cases. Report of a Case A 68-year-old man was admitted to the hospital with symptoms and physical signs of intestinal obstruction. The diagnosis was confirmed by roentgenograms. Three years before, the patient had had sigmoid colectomy for chronic volvulus. Two months later, he had mechanical intestinal obstruction, which, during a 48-hour trial, failed to respond to intestinal decompression with a Miller-Abbott tube. Abdominal exploration was required for enterolysis. Two enterotomies had to be done to decompress References 1. Crikelair, G.F., and Hiratzka, T.: Intraperitoneal Mercury Granuloma , Ann Surg 137:494-496 ( (Oct) ) 1953.Crossref 2. Siversten, cited by Wangensteen, O.H.: Intestinal Obstructions , ed 3, Springfield, Ill: Charles C Thomas, Publisher, 1955, p 232. 3. Harris, F.I.: A New Rapid Method of Intubation With the Miller-Abbott Tube , JAMA 125:784-785 ( (July 15) ) 1944.Crossref 4. Wild, J.J.: Apparatus for Intestinal Intubation , Brit Med J 6:815-816 ( (June) ) 1944. 5. Cantor, M.O.: Mercury Lost in the Gastrointestinal Tract , JAMA 146:560-561 ( (June 9) ) 1951.Crossref 6. Hoffman, I.L.: Spontaneous Evacuation of Metallic Mercury From the Vermiform Appendix , Bull US Army Med Dept 8:802-803 ( (Oct) ) 1948. 7. Birnbaum, W.: Inflammation of the Vermiform Appendix by Metallic Mercury , Amer J Surg 74:494-496 ( (Oct) ) 1947.Crossref 8. Kristoffersen, K.: Metallic Mercury as the Cause of Intestinal Ulceration , Nord Med 62:1388-1389 ( (Sept) ) 1959. 9. Bradford, F.E.; Hugo, G.J.; and Quinn, W.F.: Persistent Rectal Fistula Due to Metallic Mercury , Amer J Surg 93:74-76 ( (Jan) ) 1957.Crossref 10. Lindenmuth, W.W.: Fecal Fistula Due to Metallic Mercury From a Miller-Abbott Tube , JAMA 141:986-987 ( (Dec 3) ) 1949.Crossref 11. Hanselman, R.C., and Meyer, R.H.: Complications of Gastrointestinal Intubation , Int Abstr Surg 114:207-208 ( (June) ) 1962. 12. Farrell, J.J., and Reams, G.B.: Abuse of Intestinal Intubation , Amer Surg 23:401-408 ( (May) ) 1957. 13. Vare, V.B., Jr.: Extravasated Metallic Mercury Simulating Osteomyelitis , US Armed Forces Med J 4:773-775 ( (May) ) 1953. 14. Cantor, M.O.: Intestinal Intubation , Springfield, Ill: Charles C Thomas, Publisher, 1949, p 279. 15. Leonard, A.S., et al: Intestinal Decompression: Use of a Long Tube With a Coiled Spring Which Achieves Relief on Distension Without Enterotomy or Enterostomy , Surgery 49:440-449 ( (April) ) 1961.

Journal

Archives of Surgery – American Medical Association

Published: Oct 1, 1968

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