A 69 year-old Caucasian female, was admitted to the Intensive Care Unit after ingesting 500 milliliters of fresh white paint (synthetic enamel) with auto-injury purposes. The patient had past medical history remarkable for depressive syndrome. On admission, she was awake and alert with a Glasgow coma scale of 15. Her mental status rapidly deteriorated and even though initially there was no organic injury observed; however, she was endotracheally intubated for airway protection, as aspiration was a primary concern. Urine toxicology was negative.
An abdominal X-ray was performed, revealing radio-opaque material in the stomach and bowel. The stomach was dilated. Gastric lavage was then performed, and paint residues obtained. A “Flocculant solution” consists of 30 mililiters of clear of egg, 10 milliliters of olive oil and 30 milliliters of lactulose were administered nasogastrically every eight hours. Throughout the next 48 hours the elimination of paint residues were noted in the feces. A repeat abdominal X-ray was obtained (Figure 3 ), revealing disappearance of the radio-opaque material from the stomach, with residual material in the colon (Figure 3 ).
Sedation was discontinued after 72 hours, and extubation was performed without complications. There were no signs of hemodynamic or renal dysfunction. Finally, the patient was referred to psychiatry service.
Santiago Herrero, Moises Hernandez
