Onur Yesil

Potassium permanganate ingestion as a suicide attempt

Potassium permanganate is a highly corrosive, water-soluble oxidizing antiseptic. A 68-year-old female patient was admitted to our Emergency Department after ingestion of 3 tablets of 250 mg potassium permanganate as a suicide attempt. The physical exam revealed brown stained lesions in the oropharynx. Emergency endoscopy was performed by the gastroenterologist after the third hour of ingestion. Emergency endoscopy revealed multiple superficial (Grade I-II) lesions on the esophagus and cardia, which were considered secondary to the caustic substance. The mainstay in the treatment of potassium permanganate is supportive and the immediate priority is to secure the airway. Emergency endoscopy is an important tool used to evaluate the location and severity of injury to the esophagus, stomach and duodenum after caustic ingestion. Patients with signs and symptoms of intentional ingestion should undergo endoscopy within 12 to 24 h to define the extent of the disease.

Carotid Artery Dissection with Minor Trauma And Minor Symptoms

Introduction: Traumatic carotid artery dissection is a rare but signifi cant cause of ischemic stroke in young population. The delay in the diagnosis may lead to life long morbidity or even death. Symptoms may be delayed to several weeks. We are presenting a case with right internal carotid artery dissection after a low velocity motor vehicle accident with minor nonspecific symptoms. Case: 31 year old woman came to the emergency room on foot, two hours after having a low velocity motor vehicle accident. She did not have any specific complaint. She described hyperextension-flexion in jury and there was no direct trauma to head and neck. She had mild tenderness over right cervical paravertebral muscles. Systemic and neurological examination was normal. Cranial and Cervical CT scans were normal. CT angiography revealed dissection of the right internal carotid artery. No complication was observed after anticoagulation. Discussion/Conclusion: Carotid artery dissection may not always fulfill the screening criteria for blunt cerebrovascular injury. Emergency physicians should be suspicious about the vascular pathologies for all head and neck injuries. The most important clue is the injury mechanism. Detailed history must be obtained and patients should be asked in terms of transient symptoms.