Abstract
A 61-year-old woman ingested approximately 90 Slow-K® tablets in a suicide attempt. Approximately 90 min after the incident, the patient was admitted to the hospital in a state of cardiopulmonary arrest, and her electrocardiogram showed ventricular tachycardia (VT). Therefore, the patient was administered advanced cardiovascular life support (ACLS). However, because VT persisted, percutaneous cardiopulmonary support (PCPS) was initiated. Moreover, as initial examination showed a plasma potassium level of 11.6 mEq/L, hemodialysis (HD) was initiated. Abdominal radiography showed numerous radiopaque pill fragments in the stomach; therefore, with the patient on PCPS and HD, gastroscopy was performed to remove the pill fragments. Consequently, the patient recovered from the acute effects of the overdose and was discharged from the ICU on the 26th day after admission. Furthermore, because bleeding and erosion were observed in the stomach on admission, gastroscopy was performed again on the 68th day, revealing narrowed fornix and middle body of the stomach. Subsequently, the patient underwent partial gastrectomy on the 81st day. In conclusion, hyperkalemia and arrhythmia can occur with massive Slow-K® overdose even in individuals with normal renal function. Moreover, during the treatment for Slow-K® overdose, managing hyperkalemia as well as treating late gastric stenosis is important.
