Welcome to this month’s What’s Your Diagnosis Challenge!
But before we begin, check to see if you got the previous case on Diagnosis and Management of Acute Mesenteric Ischemia in the Emergency Department correct.
Case Presentation: Alkali Exposure: An Evidence-Based Approach to Diagnosis and Treatment
A 3-year-old boy is brought to the ED by his parents after swallowing a “drain cleaner”…
- The parents say that they had stored drain cleaner in an old soda bottle with a twist-off cap, and the boy mistook it for a beverage.
- Soon after ingestion, while at home, the patient vomited once and started crying. The parents said they washed the boy’s face and mouth with cold water at home and gave him water to drink before bringing him to the ED.
- His vital signs are: temperature, 37.2°C; heart rate, 100 beats/min; blood pressure, 96/67 mm Hg; and respiratory rate, 20 breaths/min.
- The boy is currently asymptomatic, and you wonder: since he looks so well, is observation the best approach? If so, for how long?
Case Conclusion
You performed a physical examination of the patient and noted that he did not have any dermal burns or conjunctival erythema, eye lacrimation, or photophobia. His eyes had extraocular movements intact, and his pupils were equal and reactive bilaterally. There were no oropharyngeal lesions and the patient’s vital signs were within normal limits. Since the patient was currently asymptomatic, you decided to observe him for 8 hours in the ED. After this observation period, the patient remained asymptomatic, and you decided to discharge him home after educating the parents on the importance of storing chemicals in their original containers in the home.
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Last Updated on March 13, 2025
