MASSIVE ORAL INGESTION OF ELEMENTAL MERCURY

A 42 year old male, while repairing a sphygmomanometer, intentionally ingested an estimated 3 kg (220 mL) of metallic mercury. During admiss ion, only tremor, iff itability, forgetfulness and fatigue were noted. There were no obvious gastrointestinal or hepatic complications. Bloo d and urine mercury levels were significantly elevated. Most of the me tallic mercury was cleared from the gut within 10 days. A few months l ater, hepatic dysfunction with jaundice developed. Serial investigatio ns did not suggest a viral etiology or alcoholism. Liver function test s and blood and urine mercury levels returned to normal over the next 10 months. The observation suggests that massive and prolonged retenti on of metallic mercury may facilitate the conversion of metallic, elem ental mercury to divalent mercury and its subsequent absorption with d evelopment of hepatic dysfunction.