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Massive penny ingestion: the loot with local and systemic effects
Saurabh S Dhawan1, Katherine M Ryder, Elizabeth Pritchard
1Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, Tennessee 38103, USA.
The Journal of Emergency Medicine
|January 9, 2008
Summary
Massive coin ingestion led to zinc poisoning and multiple organ dysfunction in a schizophrenic woman. This case highlights an unusual cause of severe toxicity and diagnostic challenges in adults.
Area of Science:
- Toxicology
- Internal Medicine
- Radiology
Background:
- Coin ingestion is a common cause of foreign body ingestion, particularly in children.
- While rare in adults, massive coin ingestion can lead to significant health complications.
Observation:
- A 57-year-old woman with schizophrenia presented with symptoms including lethargy, nausea, vomiting, and anorexia following coin ingestion.
- Radiological examination revealed massive coin ingestion, leading to suspicion of zinc toxicity.
Findings:
- The patient developed multiple organ dysfunction, including hepatitis, pancreatitis, severe anemia with bone marrow suppression, extravascular hemolysis, and acute renal failure.
- Prolonged exposure to zinc from the ingested coins was identified as the cause of the severe poisoning.
- This case represents an unusual instance of zinc poisoning secondary to coin ingestion in an adult.
Implications:
- This case underscores the potential for severe zinc toxicity from massive coin ingestion in adults, a rarely reported phenomenon.
- It highlights the importance of considering coin ingestion as a cause of unexplained multi-organ failure in adults.
- The study also discusses challenges in the radiological diagnosis of massive coin ingestion.
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