Pancreatic injury following acute methanol poisoning

Background: Methanol ingestion is a cause of potentially life-threatening p oisoning with numerous systemic manifestations, Clinicians may overlook the possibility of acute pancreatitis in this setting. The objective of this p aper is to document the incidence of this complication in a series of 22 pa tients and to discuss the respective role of methanol and ethanol in its pa thogenesis, Case Report: A 54-year-old woman developed acute necrotizing pa ncreatitis following acute methanol poisoning, She was treated by hemodialy sis, ethanol infusion, and folinic acid, but, despite maximal supportive th erapy, she died from multiple organ failure 54 hours after the ingestion, C ase Series: In a series of 22 consecutive patients admitted with a diagnosi s of acute methanal poisoning, we found evidence of pancreatic damage in 11 patients. The abnormalities were present from admission and before ethanol therapy in 7 cases and developed after ethanol therapy in 4 cases. Seven p atients had a history of chronic ethanol abuse, but no patient had previous ly suffered from acute or chronic pancreatitis. Three patients presented mo derate-to-severe acute pancreatitis according to clinical and radiological criteria and required aggressive supportive therapy Including peritoneal di alysis, One patient died from the direct consequences of acute necrotizing pancreatitis and 2 fully recovered from this event. Three patients evolved to brain death; autopsy revealed hemorrhagic lesions in the pancreas in onl y 1 case, Conclusions: Clinical, biological, and radiographic signs of acut e pancreatic injury may be more common than previously realized, Acute meth anol poisoning appears to produce pancreatic injury, although antidotal tre atment with ethanol or prior chronic ethanol abuse may be contributing fact ors. Because ethanol treatment may complicate the pancreatic injury, fomepi zole (4-methylpyrazole) may be the preferable antidote in acute methanol po isoning.