DOI: 10.36347/sjmcr.2019.v07i01.008

Pages: 26-27

An eighty-year-old woman was found by her family in an unconscious state. She was transported to our hospital by an ambulance. She had Sjögren's syndrome, depression and had overdosed two times in the past. On arrival, she was in a deep coma and shock state. Physiological and neurological studies revealed no specific findings. As her initial glucose level was 46 mg/dl, a 50% glucose infusion was administered; however, her consciousness did not improve. A urinary drug screening test was positive for benzodiazepine. Head brain computed tomography (CT) revealed no specific findings. Truncal CT showed a high density fluid level in the fundus of her stomach. Her history of repeated overdose, the positive urinary drug screening test and abdominal CT findings strongly suggested that she had overdosed again. She was admitted to our hospital. Her consciousness became clear on the third day and the patient reported that she had had overdosed again. A high-density fluid level at the bottom of the stomach on CT predicted overdose with high specificity. Accordingly, this finding may be usefulness for evaluating patients with diminished consciousness. Keywords: overdose; abdominal CT; high-density fluid level; stomach.