Warfarin
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Gallbladder perforation in an elderly patient: case report A 76-year-old depressed man contracted a gallbladder perforation after attempting suicide by ingestion of caustic substances, including warfarin (rat poison) [dosage not stated].* The man drank a mixture of warfarin tablets and naphthalene dissolved in window cleanser, and was taken to a hospital with nausea and vomiting 6 hours later. He could not tolerate oral active carbon and was hospitalised with new-onset abdominal pain 8 hours post-ingestion. Examination revealed abdominal tenderness with mild rebound. Laboratory investigations showed minimally elevated AST and ALT levels, a WBC count of 15 700, a haemoglobin level of 14 g/dL and mild respiratory alkalosis. Diffuse free fluid was evident on abdominal ultrasound. Acute abdomen was diagnosed, and the man underwent emergency laparotomy. During surgery, two litres of bile were noted in the abdominal cavity and the gallbladder wall appeared damaged. Cholecystectomy then revealed a 1.5cm hole in the gallbladder wall, leaking bile. Histological examination of the resected specimen showed intensive inflammatory changes of the gallbladder wall. He had normal liver function and blood values on discharge 5 days after surgery. * It was not clear whether he ingested a therapeutic product or rat poison. Moran M, et al. A case of gallbladder perforation in elderly who attempted suicide. 803031724 Turk Geriatri Dergisi 13: 133-135, No. 2, 2010 - Turkey
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Reactions 14 Aug 2010 No. 1314
