Journal of Clinical Toxicology
Open Access

Abstract

Utility of Upper Gastrointestinal Endoscopy for Management of Patients with Roundup Poisoning

Kenji Iwai, Masato Miyauchi, Daisuke Komazawa, Ryoko Murao, Hiroyuki Yokota and Atushi Koyama

Introduction: Roundup® is a herbicide widely used in Japan in gardening and agriculture. When ingested, Roundup is highly toxic, but gastrointestinal decontamination, including gastric lavage, is not routinely performed after ingestion. Endoscopy may be useful in managing individuals with liquid herbicide poisoning, by identifying gastric residual contents, assessing mucosal damage and retrieving herbicide directly by aspiration.

Case report: A 73 year old, 40 kg female with a history of depression was transported to our emergency room by ambulance 1 h after attempting suicide by ingesting 100 ml Roundup, which contains 48% glyphosate-potassium, and 52% surfactant and water. This volume was below a fatal dose (<5000 mg/kg), but may have caused organ dysfunction and mucosal damage. After confirming respiratory and circulatory stability and after obtaining informed consent from the patient, endoscopy (XQ 260; Olympus, Tokyo, Japan) was performed in the emergency room to retrieve residual herbicide. About 80 ml of herbicide in the stomach were aspirated endoscopically with only mild erosion observed in the mucosa of the stomach. The patient was able to resume oral intake 2 days after endoscopy and was discharged without any complications on day 5.

Conclusion: Endoscopy may be useful in cases of liquid poisoning including, Roundup, both to determine the amount of residual toxin and to remove it from the stomach.