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Endgames Case Review

Pain in right buttock after carbon monoxide poisoning

BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1233 (Published 03 June 2021) Cite this as: BMJ 2021;373:n1233
  1. Huijun Hu, specialist,
  2. Qiang Sun, specialist
  1. Department of Hyperbaric Oxygen, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
  1. Correspondence to: Q Sun Sunqiang83{at}gmail.com

A woman in her 30s, eight weeks into her second pregnancy, was found disorientated at home. She had been lying on her right side in bed for about six hours in an airtight room with a coal stove that had nearly burnt out. On admission to the emergency department, she had a Glasgow coma scale score of 8 and her serum carboxyhaemoglobin level was 25%. Acute carbon monoxide poisoning was diagnosed.

The patient was assessed by a gynaecologist on admission. No fetal heart beat was detected on ultrasonography.

Chest computed tomography was requested to rule out pneumothorax before hyperbaric oxygen therapy was initiated for carbon monoxide poisoning.1

After 10 hours of hyperbaric oxygen therapy the woman regained full consciousness, and she mentioned pain in her right buttock. Examination revealed mild swelling and tenderness over the area. She had reduced sensation over her right thigh, but nothing else was found on neurological examination.

Her urine was dark.

Table 1 shows the results of other relevant investigations.

View this table:
Table 1

Results of laboratory tests

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