Rupture of spleen at colonoscopy

W R Ellis, J M Harrison, R S Williams
1979 BMJ (Clinical Research Edition)  
307 proportionating system was dismantled and a gas leak found in the Cambridge Bourdon tube type dialysate temperature gauge which caused the needle pointer to register about 20'C too low. The fault had come on over a period of time and, unfortunately, it had been assumed that the Cambridge gauge was indicating the true dialysate temperature. Therefore the back-up temperature alarm system and the dialysate heater were adjusted to maintain the Cambridge gauge recording in the range 35-41°C.
more » ... ably, however, the dialysate was much hotter (possibly as much as 58°C). Comment There are three reports of patients exposed to overheated dialysate. Fortner et all reported the death of a patient who developed gross haemolysis after accidentally dialysing with a bath at 55°C. Two patients had chronic haemolysis after being exposed to 47°C dialysate for 95 minutes2 and 50'C for 110 minutes; respectively. In-vitro experiments' have shown morphological changes in red cells heated to X51-C, regardless of the time of exposure. Temperature < 47°C produced no morphological changes, irrespective of the duration of exposure, and intermediate temperatures caused changes that were dependent on both temperature and exposure time. Heatdamaged canine erythrocytes reinjected into dogs suffered acute haemolysis if heated to -51°C and chronic haemolysis if heated to between 47°C and 51-C.4 We think that our patient's two episodes show both types of heat-induced haemolysis.
doi:10.1136/bmj.1.6159.307-a pmid:421092 pmcid:PMC1597702 fatcat:rt276shyzbfcdnevkqm6s2ouka