Fatal Course of a Suicidal Intoxication with Hydrochloric Acid

Koschny, Ronald; Herceg, Maria; Stremmel, Wolfgang; Eisenbach, Christoph

doi:10.1159/000350189

Cited by 9 publications

(6 citation statements)

References 26 publications

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“…In our study the majority of complications were observed in patients after acid ingestion. Several studies have also reported less favorable outcome for acid ingestion [ 6 , 7 , 32 , 33 , 34 , 35 , 36 ]. Hydrochloric acid caused severe complications in the whole group of patients and, especially, severe complications were present in the elderly group.…”

Section: Discussionmentioning

confidence: 99%

“…Hydrochloric acid is a widespread industrial product used in numerous countries as a rust remover, pool cleaner, drain and toilet bowl cleaner, and in other household products [ 30 , 34 , 37 ]. Severe, even fatal, intoxications were reported from several European countries [ 6 , 33 , 34 , 35 , 36 ]. According to the European chemical agency (ECHA) legislation there are no restrictions in registration or use of hydrochloric acid-containing products in EU [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

“…Diluted acids or alkalis usually induce limited mucosal damage. In contrast, concentrated caustic agents with pH <2 or >12 can result in severe esophageal damage with either colliquative (alkali) or coagulative necrosis (acids) and, at the same time, a wide range of gastrointestinal injuries which can lead to late post-corrosive complications [ 3 , 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Caustic Ingestion in the Elderly: Influence of Age on Clinical Outcome

et al. 2017

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Caustic poisonings are still associated with many fatalities. Studies focusing on the elderly are rare. The purpose of the present study was to compare the clinical outcomes of caustic ingestion injury in elderly and non-elderly adults with regard to gender, intent of exposure, substance ingested, severity of mucosal injury, complications, and mortality. Caustic substance exposures reported to the National Toxicological Information Centre in Slovakia during 1998–2015 were reviewed retrospectively. The patients were divided into two groups: the non-elderly (<60 years) and elderly adults (≥60 years). The mortality rate in the elderly was significantly higher (elderly 23.0% vs. non-elderly 11.3%; p = 0.041). The risk of fatal outcome in the elderly was increased by acid ingestion (OR = 7.822; p = 0.002), particularly hydrochloric acid (OR = 5.714, p = 0.006). The incidence of respiratory complications was almost two times higher in the elderly was 31.1% vs. 17.4% for the non-elderly (p = 0.037). Respiratory complications significantly correlated with an increased mortality rate (p = 0.001) in the elderly whereas there was no association between GI complications and mortality in the elderly (p = 0.480). Elderly patients with respiratory complications had the poorest clinical outcomes. The highest risk of complications and fatalities was observed in patients after hydrochloric acid ingestion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Caustic Ingestion in the Elderly: Influence of Age on Clinical Outcome

et al. 2017

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“…Ingestion of concentrated alkali is associated with severe esophageal damage and liquefactive necrosis, whereas ingestion of concentrated acids causes coagulative necrosis and gastrointestinal damage [7]. Perforation peritonitis, especially in cases of sulfuric acid ingestion, has been reported [8]. More dilute acids are associated with less severe damage to the mucosa.…”

Section: Introductionmentioning

confidence: 99%

Unusual cutaneous presentation in a corrosive acid ingestion

Mittal

Gupta

Meshram

et al. 2021

Journal of Forensic Sciences

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Corrosive digestive tract injuries are considered to be a source of morbidity and mortality worldwide. The cases of acid ingestion in Forensic Medicine practice are not infrequent. Corrosive ingestion usually presents with injuries over the face, oropharynx, esophagus, and gastrointestinal tract. We report a case of a 65-year-old woman who was brought to the emergency department with a history of ingestion of toilet cleaner at her home. Following this, she developed blackish-brown discoloration over the abdomen. The patient survived for less than one day. An autopsy confirmed the perforation of the stomach and small intestine. 500 ml of blackish fluid was present in the peritoneal cavity which resulted in corrosive peritonitis. The chemical examiner's report showed corrosive mixtures comprising sulfate, nitrate, and chloride ions in the peritoneal contents. This case report highlights atypical cutaneous presentation over the abdomen following corrosive acid ingestion, which has not been reported previously. The possible explanation for this cutaneous manifestation was corrosive effects of the underlying viscera due to its close proximation to the abdominal wall and presence of minimal intra-abdominal fat. A direct physical connection between perforation and cutaneous findings was not identified. The case emphasizes the need for a comprehensive approach in managing such cases, analyzing ingested material, and following standard autopsy protocols in case of death.

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“…Diluted acids or alkalis generally cause limited mucosal damage. In contrast, concentrated caustic agents with pH <2 or >12 can cause severe esophageal damage as well as a wide range of gastrointestinal injuries (2)(3)(4)(5). Most patients with mild injuries recover without serious consequences.…”

Section: Introductionmentioning

confidence: 99%

Retrospective Evaluation of Corrosive Substance Ingestion: Single Center Experience

Akkuzu¹,

Sezgın²,

Özdoğan³

et al. 2019

Istanbul Med J

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Amaç: Kostik madde içilmesi yüksek morbidite ve mortalite nedeniyle ciddi bir sorun teşkil etmektedir. Evlerde kullanılan kimyasal ürünler, farklı yaşlardaki kişilerde görülebilen kaza veya kasıtlı olarak kostik maruz kalmaların kaynağıdır. Kostik maddelerin dokuda ürettiği lezyonların ciddiyeti, alınan kostik maddenin türüne, miktarına ve konsantrasyonuna, ayrıca mukoza ile temas zamanına bağlıdır. Bu çalışmada, üniversite hastanemize koroziv madde içilmesi nedeniyle başvuran hastalarımızın demografik özelliklerini, endoskopik sonuçlarını, klinik bulgularını ve komplikasyonlarını değerlendirmeyi amaçladık. Yöntemler: Hastanemize koroziv madde alımı nedeniyle 2013-2019 yılları arasında başvuran yetişkin hastaları geriye dönük olarak hastane veri kayıt sisteminden tespit ettik. Akut korozif madde alımlı 75 erişkin hastanın, alımdan sonraki 24 saat içinde endoskopi gereksinimi ve endoskopi yapılmış olanların endoskopi bulgularını inceledik. Bulgular: Hastaların 43'ü (%57) kadın, 32'si (%43) erkekti. Erkeklerin yaş ortalaması 39,3±14,50, kadınların yaş ortalaması ise 34,1±16,91 yıl idi. On altısında (%21,3) koroziv madde alımı intihar amaçlı olup, 59'unda (%78,6) yanlışlıkla alım şeklindeydi. Otuz yedi (%49,3) hasta asemptomatik olup endoskopi gerektirmedi, 7 (%9,3) hastaya endoskopi önerilmesine rağmen hastalar endoskopiyi kabul etmedi. On beş (%20) hastada endoskopi normal, 9 (%12) hastada özofajit Los Angeles (LA) grade A, 5 (%6,6) hastada özofajit LA grade B, 1 (%1,3) hasta kristal lavabo açıcısı içmiş olup özofajit LA grade D mevcuttu. Bir (%1,3) hasta da tiner içmiş olup özofageal polip, Schatzki halkası şeklinde raporlanmıştı. Alınan maddelere baktığımızda 25 (%33,3) hastada çamaşır suyu içimi mevcuttu. Koroziv madde içimine bağlı mortalite yoktu. Sonuç: Kostik madde içimleri sıklıkla yanlışlıkla olup, hafif semptomlar veya özofageal hasar ile geçmektedir. Özellikle çamaşır suyu veya yumuşatıcı içen asemptomatik kişilerde endoskopi yapılmayabilir. İntihar amaçlı alımlarda hastalar

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Fatal Course of a Suicidal Intoxication with Hydrochloric Acid

Cited by 9 publications

References 26 publications

Caustic Ingestion in the Elderly: Influence of Age on Clinical Outcome

Caustic Ingestion in the Elderly: Influence of Age on Clinical Outcome

Unusual cutaneous presentation in a corrosive acid ingestion

Retrospective Evaluation of Corrosive Substance Ingestion: Single Center Experience

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