Gastrointestinal Hemorrhage in Aluminum Phosphide Poisoning

Hugar, Basappa S; Praveen, S; Jayanth, SH; Kainoor, Sunilkumar; Shetty, Akshith Raj S

doi:10.1111/1556-4029.12588

Cited by 7 publications

(4 citation statements)

References 8 publications

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“…Life threatening upper gastrointestinal hemorrhage after ingestion of AlP has been reported, and it is thought to occur due to the corrosive effects of phosphides and phosphine on body tissues. 34 , 35 There were two patients who had bloody vomiting in our study.…”

Section: Discussionmentioning

confidence: 87%

Clinical Profile and Treatment Outcome of Aluminum Phosphide Poisoning in Felege Hiwot Referral Hospital, Northwest Ethiopia: A Retrospective Study

Bogale¹,

Ejigu²,

Muche³

2021

OAEM

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Background Aluminum phosphide (AlP) is an effective fumigant and rodenticide which is a commonly used agent for self-poisoning in parts of Ethiopia. AlP poisoning results in serious manifestations involving many vital organs and it has high mortality. Despite its high incidence and mortality, studies on AlP poisoning in Ethiopia are lacking. Our objective was to study the clinical profile and treatment outcome of AlP poisoning in Felege Hiwot Referral Hospital (FHRH), a major referral hospital in Ethiopia. Methods It is a retrospective study conducted over all consecutive AlP poisoning cases who presented to the emergency department (ED) of the hospital from March 2018 to August 2020. A questionnaire was used to collect data from patient medical records. All data were analyzed using SPSS 25. Results A total of 125 patients were studied. Females were 57.6% and males were 42.4%. Age of patients ranged from 12 to 60 with mean age 28.5 years. The average number of AlP tablets taken was 1.2 (3.6 gm) and the average time of arrival to hospital after AlP ingestion was 4.8 hours. Nausea and vomiting were the commonest presenting features seen in 74.4% of the cases followed by hypotension which was seen in half of the cases. A wide range of laboratory findings and complications were also observed. Cases of AlP poisoning with hypotension were managed in the ICU with dopamine infusion, magnesium sulphate, hydrocortisone, and calcium gluconate in addition to gastric lavage and fluid administration. Those cases without hypotension were managed with gastric lavage and maintenance fluid only. Overall mortality from AlP poisoning was 31.2%. Conclusion With a treatment protocol used in FHRH, mortality from AlP poisoning was 31.2%. Using this protocol in resource limited settings might give opportunities to reduce mortality from AlP poisoning.

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Section: Discussionmentioning

confidence: 87%

Clinical Profile and Treatment Outcome of Aluminum Phosphide Poisoning in Felege Hiwot Referral Hospital, Northwest Ethiopia: A Retrospective Study

Bogale¹,

Ejigu²,

Muche³

2021

OAEM

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“…Other causes of death in a person surviving for more than a day include adult respiratory distress syndrome, upper GI hemorrhage, metabolic disorders, and liver failure. Both metal phosphides and phosphine have corrosive actions, which play a role in causing extensive hemorrhage and ulcerations in the GI tract [7]. However, lower GI hemorrhage associated with ALP poisoning has not been reported, which, in this case, led to the mortality of our patient.…”

Section: Discussionmentioning

confidence: 68%

“…The local corrosive action of ALP may lead to extensive hemorrhages and ulceration along the GI tract [7]. Upper GI hemorrhages and esophageal stricture formation have been observed in cases of ALP poisoning [8].…”

Section: Introductionmentioning

confidence: 99%

Bowel Gangrene Is a Rare but Dreaded Complication of Aluminum Phosphide Poisoning

Chandel¹,

Dheeraj²,

Jithesh³

et al. 2022

Cureus

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Poisoning is a significant contributor to mortality and morbidity throughout the world, and one of the most common pesticide poisonings is organophosphates, followed by phosphides. Ingestion of aluminum phosphide can induce severe gastrointestinal irritation leading to hemorrhage and ulcerations. Gastrointestinal ischemia, gangrene, and hemorrhage in the ileum secondary to aluminum phosphide poisoning have not been reported in the literature. The authors report a case of an 18-year-old man who had consumed 10 grams of Celphos, aluminum phosphide powder. The patient developed lower gastrointestinal ischemia and hemorrhage due to the direct effect of aluminum phosphide, leading to bowel gangrene. The gangrenous segment caused fecal peritonitis and sepsis, leading to multiorgan failure and death. This case report emphasizes the significance of the corrosive nature of aluminum phosphide; lower gastrointestinal hemorrhage is a rare but fatal complication of aluminum phosphide poisoning.

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“…Furthermore, it does not involve a single organ, leading to multiple organ failure [16]. The effects of poisoning include damages to the heart, lungs, kidneys, and liver, as well as symptoms, such as cardiac arrhythmias, acidosis, and pulmonary edema [17,18]. Heart failure, arrhythmia, seizures, coma, and the delayed onset of liver and kidney toxicity may also occur [18].…”

Section: Introductionmentioning

confidence: 99%

Successful Treatment of Acute Aluminum Phosphide Poisoning by Aloe Vera Syrup: A Case Report

Shakeri

Soroosh

Shakeri

et al. 2021

IJMTFM

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Background: Aluminum phosphide, known as rice pill in Iran, is a very effective pesticide for commercial and industrial ‎use. The high lethality of Aluminum phosphide is due to Phosphine gas (PH3) which is released by its ‎reaction with water. One of the most important properties of aluminum phosphide, which despite being ‎very lethal to almost all living creatures, still makes it one of the most widely used pesticides, is its very ‎high yield, ease of use, and, most importantly, the absence of residues in products after application; while ‎its exposure to the human body is associated with high mortality.‎ Case Presentation: In this article, we reported the successful treatment of rice pill-induced poisoning in a 30-year-old man using a novel approach. Accordingly, we used sodium bicarbonate (50 ccs) and aloe vera syrup (1-2 L), followed by olive oil (150 cc olive oil was given every 2 hours). Conclusion: While numerous studies recommend observing patient conditions as the treatment approach, our presented case was a successful experience of treating acute aluminum phosphide poisoning.

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Gastrointestinal Hemorrhage in Aluminum Phosphide Poisoning

Cited by 7 publications

References 8 publications

Clinical Profile and Treatment Outcome of Aluminum Phosphide Poisoning in Felege Hiwot Referral Hospital, Northwest Ethiopia: A Retrospective Study

Clinical Profile and Treatment Outcome of Aluminum Phosphide Poisoning in Felege Hiwot Referral Hospital, Northwest Ethiopia: A Retrospective Study

Bowel Gangrene Is a Rare but Dreaded Complication of Aluminum Phosphide Poisoning

Successful Treatment of Acute Aluminum Phosphide Poisoning by Aloe Vera Syrup: A Case Report

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