Idiopathic Bilateral Diaphragmatic Paralysis Combined with Acute Pancreatitis

Bilateral diaphragmatic paralysis(BDP) is a rare disorder, which can be secondary to spinal cord injury, motor neuron disease, myopathy, noninfectious polyneuropathy, infection, iced saline cardioplegia performed during cardiac surgery, or idiopathic causes. there may be typical presentations such as dyspnea, paradoxical respiratory movement, and hypercapnic respiratory failure. It needs to exclude above secondary causes to consider idiopathic bilateral diaphragmatic paralysis. We report a 51-years-old man who presented with idiopathic bilateral diaphragmatic paralysis combined with acute pancreatitis. We couldnt, find out the association of these two clinical conditions. The patient was improved by mechanical ventilation.

Two cases of Anticholinergic Toxicity After Jimson weed Ingestion

Jimson weed, also known as Datura stramonium, is a member of the Solanaceae family. Jimson weed was used by American Indians for medicinal and religious purposes. All parts of the Jimson weed plant are poisons, containing the alkaloids atropine, hyoscyamine and scopolamine. So, it is caused by these components to make a anticholinergic toxicity within 6h after ingestion. Initial manifestations include dry mucus membrane, blurred, vision, thirst, difficulty swallowing and speaking, and photophobia, and may be followed by hyperthermia, confusion, agitation, combative behavior, hallucination, urinary retention, seizure and coma. We experienced two patients who developed combative behavior and agitation with pupil dilation caused by Jimson weed. They discharged with improvement after supportive for 2days.

A CLINICAL STUDY OF FOREIGN BODY INGESTION

We analyzed records at Chonnam university hospital from Sep. 1. 1993 to Aug. 31. 1996 to assess clinical significance of the foreign body in the gastrointestinal tract. There were 133 episodes consisting of 79 pediatric and 54 adult patients as possible to review. In the pediatric patients, the coin was the most common cause of foreign body ingestion, while adult patients were usually caused by bones and meat. We removed foreign bodies in the oral cavity and oropharynx in 12 cases using direct laryngophanmgoscpy and forcep. Endoscopy was performed successfully in 47 of 51 patients in which was attempted; there were two complications composed of an aspiration pneumonia and a mediastinitis due to esophageal perforation. There were spontaneous passage of foreign bodies in 48 cases. We observed complications in 6 cases in which 4 cases needed operations due to complications. Foreign bodies which pass into the stomach can be observed for development of complications, as 94% of foreign bodies which reach the stomach spontaneously pass. Only 4 patients required interventions, which was done without mortality.