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[No Blister-Wrapped Pills: Perforation after Ingestion a Blister-Pack]
A Prokop1, H Stepper2, S Koll3
1Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Kliniken Sindelfingen, Klinikverbund Südwest.
Background:
Pills in sharp packaging that are accidentally swallowed (blisters) can cause perforations in the gastrointestinal tract, which are only clinically apparent after the emergence of mediastinitis or peritonitis. Mortality is high.
Patients:
We have seen two cases in cognitively limited patients, one with oesophageal and one with ileal perforation.
Results:
Despite surgery, the patient with oesophageal perforation died 3 weeks later of multi-organ failure. The patient with ileal perforation survived sepsis after multiple procedures.
Conclusion:
As a consequence, a hospital-wide policy was implemented prohibiting the issue of tablets in blister packaging at the bedside. No more cases have emerged since that time.
Related Concept Videos
Esophageal Perforation-I: Introduction
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
Factors Influencing Drug Absorption: Pharmaceutical Parameters
Bioavailability Enhancement: Drug Permeability Enhancement
Bioavailability Enhancement: Drug Stability Enhancement and GI Retention
Formulation and Manufacturing Process: Physical Attributes of Generic Tablets and Capsules
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