SEVERE DILTIAZEM POISONING WITH INTESTINAL PSEUDOOBSTRUCTION - CASE-REPORT AND TOXICOLOGICAL DATA

This case report concerns a 30-year-old man who survived a 4.2 g dilti azem overdose. He sustained vasoplegic shock with a junctional escape rhythm which required high doses of norepinephrine and epinephrine. Am ong other complications, ileus with paralytic intestinal pseudo-obstru ction developed on day three. Cecal distention was demonstrated by abd omen computed tomodensitometry. The ileus resolved on day seven follow ing the poisoning. Diltiazem plasma concentrations were determined dur ing the first three days. The possible role of other medications, acti vated charcoal and sufentanil, is noted.