Metabolism of barium in the human body after suicidal ingestion: A CARE-compliant case report

Thus far, barium poisoning has been seldom reported and the metabolism of barium in human body has not been explored. PATIENT CONCERNS: A 21-year-old young man was taken to the local hospital by “120 emergency medical services” after a suicidal attempt. About 100 mL of barium chloride solution with a concentration of 100 g/L was ingested, while the actual amount of ingested barium chloride solution was unclear because of immediate vomiting after the ingestion. DIAGNOSES: About 2 hours after the suicidal ingestion, the patient was presented with somnolence, the pulse rate was 67 beats per minute, the blood pressure was 158/92 mm Hg, but he exhibited no nausea or vomiting. About 3 hours after the ingestion, the blood concentration of potassium was 1.5 mmol/L. INTERVENTIONS: The patient received gastric lavage by magnesium sulfate solution, intravenous sodium thiosulfate, and potassium supplementation. Other symptomatic treatments were applied simultaneously. To investigate the metabolism of barium in the human body, we measured the concentration of barium in 9 groups of paired serum and urine samples sequentially collected from the patient. OUTCOMES: The patient was rescued successfully. LESSONS: The serum concentration of barium decreased rapidly in the first 24 hours. In this period, prompt and massive potassium supplementation and other symptomatic treatments are effective and recommended.