Abstract Twelve cases of Reye's syndrome are presented with different degrees of encephalopathy, hyperammonemia and hypoglycemia; associated to acetyl salicylic acid (ASA) ingestion. [ncbi.nlm.nih.gov]

Delayed consequences could be strictures of the oesophagus presenting as dysphagia or gastric, pyloric and antral stenosis presenting as gastric outlet obstruction. Gastro-colic fistula as a complication of acid ingestion is a rare clinical entity. [gastrores.org]

• Gastric Lavage

  We reported three cases of gastric outlet obstruction. Two of these cases were initially treated in provincial hospitals by gastric lavages. [ncbi.nlm.nih.gov]

  lavage is contraindicated in corrosive acid poisoning like sulfuric acid poisoning. [en.wikipedia.org]

  Gastric lavage by traditional methods using large-bore orogastric Ewald tubes are contraindicated in both acidic and alkaline ingestions because of risk of esophageal perforation and tracheal aspiration of stomach contents. [emedicine.medscape.com]

  COMPLICATIONS Acute complications: oral, oesophageal, gastric burns (varying thickness) – most effected = areas of anatomical narrowing (cricopharyngeal, diaphragmatic oesophagus, antrum, pylorus). oesophageal, gastric perforation shock haemorrhage mediastinitis [lifeinthefastlane.com]

• Asymptomatic

  Gastric outlet obstruction is a common late result and may develop following an asymptomatic interval. The authors' experience with three patients with severe complications following ingestion of acid is presented. [ncbi.nlm.nih.gov]

  […] at 4 hours post-ingestion -> perform a trial of oral fluids and discharge if well tolerated (avoid discharging a child at night) Some experts advocate endoscopy following corrosive ingestion even in the asymptomatic patient If symptomatic (e.g. throat [lifeinthefastlane.com]

  […] than asymptomatic adults with low risk exposure who may be discharged after observation for 2-4 hours). [pedclerk.bsd.uchicago.edu]

• Cough

  Acquired tracheoesophageal fistula following chemical injury is well reported. 3 Such patients present with cough after swallowing, which is usually worse with liquids. [japi.org]

  Coughing up blood Dizziness Low blood pressure Rapid pulse Shortness of breath Symptoms from skin or eye contact may include: Skin burning, drainage, and pain Eye burning, drainage, and pain Vision loss DO NOT make a person throw up. [medlineplus.gov]

  cough and acid reflux. [draxe.com]

  Airway burns may cause coughing, tachypnea, or stridor. Swollen, erythematous tissue may be visible intraorally; however, caustic liquids may cause no intraoral burns despite serious injury farther down the GI tract. [merckmanuals.com]

  Symptoms include hoarseness, food getting stuck, burning, irritation, nausea, coughing, wheezing, asthma symptoms and eroded tooth enamel. It also increases your odds of esophageal cancer. [mnn.com]

• Abdominal Pain

  We present the case of a 20 year old male with suicidal ingestion of Harpic, who presented with severe abdominal pain and signs of generalised peritonitis. [eprints.manipal.edu]

  pain and peritoneal signs: immediate CXR and abdominal x-ray to r/o intraperitoneal or mediastinal air Substernal chest pain, abdominal pain, rigidity → indicate profound injury or perforation of esophagus/stomach Signs of perforated viscus, peritonitis [mhmedical.com]

  Symptoms include burns to the skin and throat, abdominal pain, convulsions and tremors or even collapse. It's is advisable for the patient to drink plenty of fluids and seek medical assistance. [healamed.com]

  […] drooling odynophagia vomiting abdominal pain Upper airway injury is the most important immediate life-threat. [lifeinthefastlane.com]

  Vomiting Retching (gagging) Abdominal pain Low-grade fever Irritability Persistent drooling Difficulty breathing if the battery is blocking the airway Rash from nickel metal allergy Dark or bloody stools Although mercury-containing cells tend to fragment [emedicinehealth.com]

• Choking

  Well, you could choke, your stomach acid will erode your esophagus, the substance you swallowed could be harmful to your lungs or esophagus, and you’ll become severely dehydrated, which could actually be worse for you than the poison you ingested. [txfx.net]

  […] blood pressure (shock) Severe pain in the mouth and throat Speech problems Vomiting, with blood Vision loss Symptoms from breathing in the poison may include: Bluish skin, lips, and fingernails Breathing difficulty Body weakness Chest pain (tightness) Choking [medlineplus.gov]

  This results in choking and gagging which may lead to aspiration of the caustic material and airway compromise. Acids cause tissue damage through coagulative necrosis that forms an eschar. [pedclerk.bsd.uchicago.edu]

  […] include: ( 3 ) Heartburn Bitter taste in your mouth, periodically or (for some people) throughout the day (some people taste regurgitated food or sour liquid at the back of their mouths/throats) Waking up in the middle of the night feeling like you’re choking [draxe.com]

• Odynophagia

  If pediatric ingestion, parents should bring container of caustic ingested for correct identification Symptoms: Hoarseness, stridor, dyspnea → indicate airway injury Odynophagia, drooling, refusal of food → indicate orophayngeal/nasophayngeal and esophageal [mhmedical.com]

  […] permangante — methemoglobinemia, multi-organ failure silver nitrate — methemoglobinemia tannic acid — hepatotoxicity CLINICAL FEATURES Corrosive ingestion may result in immediate symptoms of injury to the gastrointestinal tract: mouth and throat pain drooling odynophagia [lifeinthefastlane.com]

  Patients can also present with drooling, retrosternal or abdominal pain, nausea, vomiting, hematemesis, and odynophagia. If upper airway injury is present, patients may exhibit stridor, hoarseness, nasal flaring and retractions. [pedclerk.bsd.uchicago.edu]

• Gagging

  Vomiting Retching (gagging) Abdominal pain Low-grade fever Irritability Persistent drooling Difficulty breathing if the battery is blocking the airway Rash from nickel metal allergy Dark or bloody stools Although mercury-containing cells tend to fragment [emedicinehealth.com]

  This results in choking and gagging which may lead to aspiration of the caustic material and airway compromise. Acids cause tissue damage through coagulative necrosis that forms an eschar. [pedclerk.bsd.uchicago.edu]

• Black Stools

  Speak to your healthcare professional if you experience: 01 Frequent vomiting 02 Blood in vomit 03 Weight loss or loss of appetite 04 Black stools 05 Difficult or painful swallowing 06 Shortness of breath, sweating or pain that radiates from the jaw, [rolaids.com]

  […] choking or coughing Dry mouth Gum irritation, including tenderness and bleeding Bad breath Regurgitation of acidic foods Bloating after meals and during bouts of symptoms Nausea Bloody vomiting (possible sign of damage in the lining of the esophagus) Black [draxe.com]

• Chest Pain

  She complained about chest pain and 12-lead ECG showed ST segment elevation at lead II, III, and aVF. [ncbi.nlm.nih.gov]

  […] and peritoneal signs: immediate CXR and abdominal x-ray to r/o intraperitoneal or mediastinal air Substernal chest pain, abdominal pain, rigidity → indicate profound injury or perforation of esophagus/stomach Signs of perforated viscus, peritonitis, [mhmedical.com]

  Esophageal perforation may result in mediastinitis, with severe chest pain, tachycardia, fever, tachypnea, and shock. Gastric perforation may result in peritonitis. [merckmanuals.com]

  Vision loss Symptoms from breathing in the poison may include: Bluish skin, lips, and fingernails Breathing difficulty Body weakness Chest pain (tightness) Choking Coughing Coughing up blood Dizziness Low blood pressure Rapid pulse Shortness of breath [medlineplus.gov]

  The most common symptom of GERD is frequent pains in the chest and burning sensations (hence the name “heartburn”). [draxe.com]

• Hypotension

  Symptoms included lethargy (n = 94), coma (n = 19), tachycardia (n = 24), aspiration (n = 8), metabolic acidosis (n = 8), and hypotension (n = 4). [ncbi.nlm.nih.gov]

  […] dehydration diagnosis diarrhea disease disorders dose drug dysfunction edema effects electrolyte emergency etiology evaluation factors fever fluid glucose heart failure hematuria hemolysis hemorrhage hypertension hypoglycemia hypokalemia hyponatremia hypotension [books.google.de]

  Signs of severe injury include altered mental status, peritoneal signs (evidence of viscous perforation), hypotension and shock. [pedclerk.bsd.uchicago.edu]

  Increased blood phosphate concentrations following phosphoric acid ingestion have been associated with hypocalcaemia, hypotension and acidosis (Caravati, 1987). [inchem.org]

  Hypotension, respiratory symptoms, high volume or concentration of ingested acid, hematemesis, metabolic acidosis and development of acute respiratory distress syndrome were identified as further risk factors for death. [karger.com]

• Tachycardia

  Symptoms included lethargy (n = 94), coma (n = 19), tachycardia (n = 24), aspiration (n = 8), metabolic acidosis (n = 8), and hypotension (n = 4). [ncbi.nlm.nih.gov]

  […] oxygen patients Pediatr percent perfusion plasma platelet poisoning present preterm pulmonary renal failure respiratory distress respiratory failure resuscitation risk seizures sepsis septic shock serum severe shock sodium stridor symptoms syndrome Table tachycardia [books.google.de]

  Tachycardia, tachypnoea. Shock may occur in major ingestions Stage 3: Renal Toxicity At 24-72 hrs post-ingestion Acute anuric renal failure may occur due to precipitation of calcium oxalate crystals in the renal tubules. [anaesthesiamcq.com]

  Esophageal perforation may result in mediastinitis, with severe chest pain, tachycardia, fever, tachypnea, and shock. Gastric perforation may result in peritonitis. [merckmanuals.com]

• Seizure

  […] mg/kg ml/kg monitoring neonates neurological newborn normal obstruction occur oral oxygen patients Pediatr percent perfusion plasma platelet poisoning present preterm pulmonary renal failure respiratory distress respiratory failure resuscitation risk seizures [books.google.de]

  In severe cases patient may develop seizures and loss of consciousness. Fever : Patient may have raised body temperature with flushing of skin and headache. He may often feel drowsy. [tandurust.com]

  […] shock, multi-organ dysfunction hydrofluoric acid — hypocalcemia mercuric chloride (inorganic mercury salts) — renal failure, shock oxalic acid — hypocalcemia, renal failure paraquat — pulmonary fibrosis, multi-organ dysfunction and shock phenol — coma, seizures [lifeinthefastlane.com]

  — metabolic acidosis, shock, multi-organ dysfunction hydrofluoric acid — hypocalcemia mercuric chloride — renal failure, shock oxalic acid — hypocalcemia, renal failure paraquat — pulmonary fibrosis, multi-organ dysfunction and shock phenol — coma, seizures [derangedphysiology.com]

• Convulsions

  Symptoms include burns to the skin and throat, abdominal pain, convulsions and tremors or even collapse. It's is advisable for the patient to drink plenty of fluids and seek medical assistance. [healamed.com]

  DO NOT give water or milk if the person is having symptoms (such as vomiting, convulsions, or a decreased level of alertness) that make it hard to swallow. If the person breathed in the poison, immediately move him or her to fresh air. [medlineplus.gov]

  Considering the strong suicidal intensions in the patient and as he was nil per orally overnight, emergency Electro Convulsive Therapy (ECT) was planned. [indianjpsychiatry.org]

Diagnostic Workup and Initial Treatment It is important to gather as much information about the specific agent ingested as well as the time, nature of the exposure and duration of contact. [pedclerk.bsd.uchicago.edu]

It was concluded that the hemodialysis was very useful in the treatment of boric acid poisoning, because it accelerated the elimination of boric acid about four times faster than with conventional treatment. [ncbi.nlm.nih.gov]

Long-term Treatment and Prognosis Any patient with a Grade 2 burn or higher should be followed up with an upper GI (UGI) series 2-3 weeks after ingestion. [pedclerk.bsd.uchicago.edu]

Battery Ingestion Complications and Prognosis For the majority of cases of disk battery ingestion, conservative therapy is all that is needed. The battery will pass on its own. A disk battery lodged in the esophagus is rare. [emedicinehealth.com]

Epidemiology, pathogenesis, course, complications and prognosis] UgeskrLaeger 155: 2379-2382. Marks IN, Bank S, Werbellof L, Farman J, Louw JH (1963) The natural history of corrosive gastritis: Report of five cases. Am J Dig Dis 8: 509-524. [omicsonline.org]

Early fibreoptic oesophago-gastroscopy (ideally within 24 h) by an experienced endoscopist is indicated in symptomatic patients to grade the severity of injury and determine prognosis. 8. [inchem.org]

[…] bilirubin bleeding blood pressure bradycardia cardiac cause cells cerebral chest child Clin clinical coagulation congenital cyanosis decreased dehydration diagnosis diarrhea disease disorders dose drug dysfunction edema effects electrolyte emergency etiology [books.google.de]

No abnormality that might be the etiology of hematuria was found. From our observation, hematuria should not be caused by glomerular injury because there was no dysmorphic RBC found in her urine. [degruyter.com]

Waugh 595 Activities Toward Dental Decay Prevention in Japan 605 The Relation of Carbohydrate to Lactobacillus acidophilus 613 The Dental Health of the People of New Zealand 621 Our Present Knowledge of the Relationship of Salivary Composi 631 Some Epidemiological [books.google.de]

References Lakshmi CP, Vijayhari R, Kate V, Ananthakrishnan N (2013) A hospital-based epidemiological study of corrosive alimentary injuries with particular reference to the Indian experience. Nat Med J India. 26: 31-36. [omicsonline.org]

Clinical-epidemiological characteristics in caustics ingestion patients in the Hipolito Unanue National Hospital. Rev Gastroenterol Peru 2003; 23(2):115-25. Corsi PR, Hoyos MB, Rassian S, Viana Ade T, Gagliardi D. [x-unnec-med-practice.tripod.com]

Christesen HB: Caustic ingestion in adults - epidemiology and prevention. J Toxicol Clin Toxicol 1994;32:557-568. Bosher LW Jr, Burford TH, Ackerman L: The pathology of experimentally produced lye burns and strictures of the esophagus. [karger.com]

EPIDEMIOLOGY The widespread use of phosphoric acid in industry has been the source of both chronic (Fabbri et al, 1977) and acute exposure following spillage, fire or explosion. [inchem.org]

The legal issues concerning suicide in a patient with mental illness, autopsy findings, forensic issues, and pathophysiology concerning death by acid ingestion have been discussed. [ncbi.nlm.nih.gov]

Pathophysiological and aetiological considerations Alkali ingestion Alkaline substances are easier to swallow, as it hurts less than acid (they are a more common tool of suicide) Alkaline material mainly damages the oesophagus, as the stomach contains [derangedphysiology.com]

However, because we did not perform a cystoscopic study of the urinary bladder, we could therefore not elucidate the probable pathophysiology of hematuria after acid ingestion. [degruyter.com]

Recommendations are made for diagnosis and prevention of this potentially lethal complication. [ncbi.nlm.nih.gov]

Devastating Aftermath of Suicidal Muriatic Acid Ingestion Report of Two Cases for Public Awareness and Prevention Jose Mario Amado M. Pingul, MD Nolan O. Aludino, MD Reynaldo O. [x-unnec-med-practice.tripod.com]

The goal of treatment is to prevent permanent injury of stricture formation in esophagus. [japi.org]