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Green urine: A bezoar effect.

Daniel Morell-Garcia1, Josep M Bauça1, Angela García-Suquía2

  • 1Clinical Chemistry Department, Hospital Universitari Son Espases, Carretera de Valldemossa 79, 07120, Palma de Mallorca, Spain; Instituto de Investigación Sanitaria de Palma (IdISPa), Palma de Mallorca, Spain.

Journal of Clinical Anesthesia
|August 25, 2016
PubMed
Summary

Green urine in children can be caused by methylene blue, a dye used in medical procedures. This case report highlights a rare drug bezoar effect leading to urine discoloration, even days after administration.

Keywords:
Green urineIntensive careMethylene bluePediatrics surgery

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Area of Science:

  • Medical Case Reports
  • Pediatric Urology
  • Clinical Toxicology

Background:

  • Urine discoloration, specifically green urine, can indicate underlying pathologies.
  • Various causes of green urine have been documented in medical literature.
  • Methylene blue is a dye with diagnostic and therapeutic applications.

Observation:

  • A pediatric case presented with green urine 96 hours after nasogastric administration of methylene blue.
  • Other potential causes for urine discoloration were systematically excluded.
  • Surgical manipulation of a paralytic ileus was hypothesized to trigger methylene blue reabsorption.

Findings:

  • A drug bezoar effect involving retained methylene blue in the bowel was proposed as the cause.
  • This is the first reported case of green urine due to a methylene blue drug bezoar in a pediatric patient.
  • The bezoar effect led to delayed reabsorption and subsequent urine discoloration.

Implications:

  • Healthcare providers should consider methylene blue drug bezoars as a rare cause of green urine in children.
  • Awareness of this phenomenon can prevent unnecessary diagnostic tests and interventions.
  • Early recognition aids in appropriate patient management and diagnosis.