Iron Tablets or Gallstones? Iron Overdose in Situs Inversus

Leonard Ranasinghe

doi:10.34297/ajbsr.2020.08.001260

Abstract

A 38 year-old male with a history of psychiatric illness and methamphetamine abuse presented to the emergency department (ED) reporting intentionally taking cyclobenzaprine, alprazolam, and iron tablets. He could not provide history regarding exact dosages or time of ingestion. An abdominal x-ray showed multiple radio-opacities in the right upper quadrant. (Panel A) The location and exact nature of these opacities was initially unclear. A chest x-ray suggested situs inversus. (Panel B) The foreign bodies were then found to be iron tablets located in the stomach. Whole bowel irrigation (WBI) with polyethylene glycol was instituted to decontaminate the gastrointestinal tract. Following WBI, the gastrointestinal tract was clear of all radiopaque tablets. (Panel C) The patient had no complications following the procedure and remained stable after the remaining iron tablets were removed.

Highlights

A 38 year-old male with a history of psychiatric illness and methamphetamine abuse presented to the emergency department (ED) reporting intentionally taking cyclobenzaprine, alprazolam, and iron tablets
Following Whole bowel irrigation (WBI), the gastrointestinal tract was clear of all radiopaque tablets. (Panel C) The patient had no complications following the procedure and remained stable after the remaining iron tablets were removed
Situs inversus is an rare inherent condition consisting of inversion of the major organs from their normal positions in the body

Summary

Introduction

To Cite This Article: Leonard Ranasinghe, Iron Tablets or Gallstones? (Panel B) The foreign bodies were found to be iron tablets located in the stomach. Following WBI, the gastrointestinal tract was clear of all radiopaque tablets. (Panel C) The patient had no complications following the procedure and remained stable after the remaining iron tablets were removed.

Results

Conclusion