Unusual cause of acute abdomen

ABSTRACT

Lead poisoning might be presented in different ways, and might cause a diagnostic dilemma for a treating surgeon, it is important to keep in mind adult lead poisoning as a rare cause, for a common complaint as acute abdomen. Three patients whom presented with acute abdominal pain, all were working in different facility that deals with lead and had a history of lead exposure; but they failed to reveal the true nature of their work [the first two were college student], and they had no idea of the possible relation of it with their illness. Clinical examination was helpful, and all were confirmed to have lead poisoning by blood lead level measuring. The 1st one underwent surgery [explorative laparotomy for provisional diagnosis of intestinal obstruction] as the diagnosis of lead poisoning was not made till two weeks after surgery; his illness was helpful in diagnosing the pathology for his brother illness [the second patient]. The 3[rd] one had true surgical acute abdomen [acute appendicitis] in addition to lead exposure. Eventually the three patients were notified and were referred to the poison consultation center [PCC]. They were advised to quit their job and were treated accordingly. Difficult economic circumstances may push people to work in unsafe facilities, with exposure to toxic materials; adult lead poisoning is a subtle chronic condition and might be presented as acute abdominal pain; it is important for the treating clinician to differentiate between surgical and non surgical causes of acute abdomen. These cases reveal the importance of careful evaluation of basic laboratory tests and of obtaining a detailed occupational history