Botulinum toxin A
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Gastroduodenal disorders in an elderly patient: case report An 81-year-old woman developed transient acute gastroduodenal dilation complicated by perforation after botulinum toxin A injection for the treatment of achalasia. The woman underwent botulinum toxin injection for achalasia, and her treatment was successful. However, 3 years later, she received further botulinum toxin injection via upper endoscopy under conscious sedation. She received a total dose of 100U botulinum toxin A [Botox A]. Three days later, she presented with abdominal distention and pain. An abdominal x-ray and a subsequent CT scan confirmed marked stomach and duodenum distention. The woman underwent upper endoscopy, with aspiration of approximately 6L of coffee-ground material and fluid, leading to resolution of her abdominal distention. A nasogastric tube was inserted in her gastric cavity and remained in place for 5 days. She subsequently developed severe sepsis due to abscesses caused by a gastric microperforation, and received treatment with percutaneous drainage and broad-spectrum antibacterials. She was discharged after 6 weeks; at 3 months’ follow-up, she remained asymptomatic. Radaelli F, et al. Acute reversible gastroparesis and megaduodenum after botulinum toxin injection for achalasia. Gastrointestinal Endoscopy 71: 1326-1327, No. 7, Jun 2010. Available from: URL: http://dx.doi.org/10.1016/j.gie.2009.10.034 803028909 - Italy
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Reactions 31 Jul 2010 No. 1312
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