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Subperitoneal pelvic exposure of elemental mercury from a broken thermometer

Zhen Shen1, Shan Zheng, Kuiran Dong

  • 1Department of Pediatric Surgery, Children's Hospital, Fudan University, Shanghai, China.

Clinical Toxicology (Philadelphia, Pa.)
|February 11, 2012
PubMed

Insights

A rare case of elemental mercury exposure in a 10-month-old boy occurred rectally. Laparoscopic surgery removed most deposits, and mercury levels normalized without systemic toxicity.

Area of Science:

  • Pediatric Surgery
  • Toxicology
  • Medical Imaging

Background:

  • Elemental mercury exposure, particularly in the subperitoneal pelvic region, is an uncommon pediatric emergency.
  • Accurate diagnosis and management strategies for such exposures remain challenging due to limited case data.

Observation:

  • A 10-month-old infant sustained rectal exposure to elemental mercury from a broken thermometer.
  • Imaging studies, including abdominal films and CT scans, confirmed mercury deposits within the subperitoneal pelvic cavity.
  • Elevated serum and urine mercury levels were detected, yet the infant exhibited no systemic signs of toxicity.

Findings:

  • Surgical intervention via laparoscopy successfully removed the majority of the pelvic mercury deposits.
  • Despite incomplete removal, follow-up assessments at 11 months showed normalization of serum and urine mercury concentrations.
  • No evidence of systemic mercury toxicity was observed post-intervention.

Implications:

  • This case highlights the possibility of significant elemental mercury deposition in the subperitoneal pelvic space following rectal exposure.
  • Laparoscopic surgery can be an effective, though potentially incomplete, method for removing such deposits.
  • The body's ability to clear mercury and the absence of toxicity in this case suggest a potentially favorable prognosis even with residual deposits.

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