Prediction of charcoal passing time in the gastrointestinal tract using radio-opque markers (Kolomark) in drug intoxication patients

Ji, Jae Gu; Kim, Yang Weon; Kang, Ji Hun; Park, Chang Min; Park, Chul Ho; Yoon, Yoo Sang

J Korean Soc Emerg Med > Volume 29(4); 2018 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2018;29(4): 297-303.

약물 중독 환자에서 방사선 비투과성표지자(Kolomark)를 이용한 위장관 내 활성탄 통과 시간 예측

지재구, 김양원, 강지훈, 박창민, 박철호, 윤유상

인제대학교 의과대학 응급의학교실

Prediction of charcoal passing time in the gastrointestinal tract using radio-opque markers (Kolomark) in drug intoxication patients

Jae Gu Ji, Yang Weon Kim, Ji Hun Kang, Chang Min Park, Chul Ho Park, Yoo Sang Yoon

Department of Emergency Medicine, Inje University College of Medicine, Busan, Korea

Correspondence

Ji Hun Kang ,Tel: 051-890-6120, Fax: 051-891-1465, Email: mona@hanmail.net,

Received: May 10, 2018; Revised: June 24, 2018 Accepted: July 31, 2018. Published online: August 31, 2018.

ABSTRACT

Objective:
Charcoal is the first-line treatment in drug intoxication. Prediction of the time required for charcoal to pass in patients with constipation using radio-opaque markers (Kolomark) will facilitate the treatment, progression, and discharge of patients.
Method:
From October 2017 to April 2018, we compared constipation and non-constipation groups of patients aged 15 years old and over who were treated with drug intoxication at the emergency department. To accomplish this, a radiopaque marker, Kolomark, was administered after administration of charcoal and X-rays were taken to confirm the location of the Kolomark. The rectosigmoid colon arrival time of charcoal and charcoal passing time was then measured.
Results:
Based on 48 charcoal passing times, 56 hours 42 minutes was required for its passage. The Kolomark arrival time at the rectosigmoid colon was delayed by about 47 hours in the constipation group. Additionally, the time of evacuation of the charcoal from rectosigmoid colon to stool was 15 hours 42 minutes in the constipation group, while it was 13 hours 10 minutes in the non-constipation group (P<0.05).
Conclusion:
The results revealed that charcoal is released in 13 hours 52 minutes after Kolomark arrives at the rectosigmoid colonic position. These findings may help predict the release of charcoal during treatment of patients and facilitate patient's treatment, progress, and discharge.

Key words: Charcoal; Constipation; Emergency department