Citation

Yonemaru H, Karimata H, Shimoji H, Yamamoto K, Hanashiro K, Fukami M, Ouchi G, Tamaki Y, Kondo Y, Kukita I. Acute Med. Surg. 2016; 3(2): 147-151.

Copyright

(Copyright © 2016, Japanese Association for Acute Medicine, Publisher John Wiley and Sons)

DOI

10.1002/ams2.149

PMID

29123769

PMCID

PMC5667373

Abstract

CASE: We describe the case of a female patient who ingested approximately 100 mL of toilet bowl cleaner containing 9.5% hydrochloric acid in a suicide attempt. Upon admission for hematemesis and epigastric pain, she was alert and oriented with stable vital signs. Initial contrast-enhanced computed tomography (CT) demonstrated edematous changes with no evidence of upper gastrointestinal tract perforation. Endoscopy was not performed owing to the high risk of perforation. We managed this patient conservatively. Repeat contrast-enhanced CT revealed mediastinal emphysema on day 2, which resolved by day 6. The patient was subsequently discharged with no apparent strictures of the upper gastrointestinal tract.
OUTCOME: Surgical interventions are frequently required following the ingestion of large amounts of highly concentrated hydrochloric acid; however, this patient was successfully managed conservatively.
CONCLUSION: Contrast-enhanced CT is useful in the assessment of the respiratory and digestive systems and the prediction of potential complications.

Language: en

Keywords

Caustic ingestion; computed tomography; mediastinal emphysema