Citation

Kiyota K, Suzuki T, Adachi T, Nonaka A, Nishigawa Y, Hamabe Y. Chudoku Kenkyu 2002; 15(2): 171-176.

Copyright

(Copyright © 2002, Yakugyo Jihosha)

DOI

unavailable

PMID

12108022

Abstract

A-79-year-old woman ingested a cup of unknown violet agricultural solution intentionally. She was vomiting and smelt of sulfur. Arterial blood gas showed metabolic acidosis and marked cyanosis regardless of relatively high PaO2, caused by sulfhemoglobinemia. A nasogastric tube could not be inserted because of marked stenosis caused by endoscopically proven severe corrosive chemical injury (burn) of esophagus. Considering the smell and the clinical presentation, we concluded that the causative agent was calcium polysulfide or lime-sulphur solution, a common agricultural product used as a fungicide. Despite supportive therapy including infusion of NaNO2, the patient expired 4.5 hours after ingestion. Calcium polysulfide ingestions cause direct injury to the upper gastrointestinal tract, and react with gastric HCl producing poisonous H2S gas, which interferes cytochrome oxidase activity, developing tissue hypoxia, shock, and metabolic acidosis. Sulfhemoglobin is also produced causing severe cyanosis.

Language: ja

Keywords

Aged; Burns, Chemical; Calcium Compounds; Drug Overdose; Esophageal Stenosis; Esophagitis; Esophagus; Fatal Outcome; Female; Fungicides, Industrial; Gases; Humans; Hydrogen Sulfide; Shock; Suicide, Attempted; Sulfhemoglobinemia; Sulfides; Thiosulfates