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Journal of Korean Neurosurgical Society 2011;49(4): 245-247.
doi: https://doi.org/10.3340/jkns.2011.49.4.245
Postoperative Systemic Dissemination of Injected Elemental Mercury.
Suk Hyung Kang, Seung Won Park, Kyung Yoon Moon
1Department of Neurosurgery, Chung-Ang University College of Medicine, Seoul, Korea. nspsw@cau.ac.kr
2Department of Neurological Surgery, Siheung 21 Century Hospital, Siheung, Korea.
ABSTRACT
There were only a few reports of mercury on pulmonary artery. However, there is no data on surgery related mercury dissemination. The objective of the present article is to describe one case of postoperative injected mercury dissemination. A 19-year-old man presented severe neck pain including meningeal irritation sign and abdominal pain after injection of mercury for the purpose of suicide. Radiologic study showed injected mercury in the neck involving high cervical epidural space and subcutaneous layer of abdomen. Partial hemilaminectomy and open mercury evacuation of spinal canal was performed. For the removal of abdominal subcutaneous mercury, C-arm guided needle aspiration was done. After surgery, radiologic study showed disseminated mercury in the lung, heart, skull base and low spinal canal. Neck pain and abdominal pain were improved after surgery. During 1 month after surgery, there was no symptom of mercury intoxication except increased mercury concentration of urine, blood and hair. We assumed the bone work during surgery might have caused mercury dissemination. Therefore, we recommend minimal invasive surgical technique for removal of injected mercury. If open exposures are needed, cautious surgical technique to prohibit mercury dissemination is necessary and normal barrier should be protected to prevent the migration of mercury.
Key Words: Bone work; Mercury poisoning; Postoperative complications; Transvascular dissemination
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