Death from caustic ingestion:A case report  

作　　者：Shao Hui Koh Jacqueline C.L.Tan 

机构地区：[1]Department of Emergency Medicine,Sengkang General Hospital,Singapore

出　　处：《Journal of Acute Disease》2024年第2期81-84,共4页急性病杂志（英文版）

摘　　要：Rationale:Acute caustic ingestion from suicidal intent is not usual in emergency departments in developed countries.One of the substances commonly ingested by suicidal patients,phosphoric acid,tends to cause multi-system derangements.Patient’s Concern:A 41-year-old male patient presented with complaints of throat discomfort,severe generalized abdominal pain,and multiple episodes of hematemesis after ingesting a restroom cleaning solution.Diagnosis:Poisoning by acute caustic ingestion(containing<30%phosphoric acid and<4%ethylene glycol).Interventions:The patient was administered 50 mL of 8.4%sodium bicarbonate solution followed by an isotonic sodium bicarbonate solution running at 500 mL/h,a hyperkalemia kit,ceftriaxone,metronidazole,omeprazole,and atropine.The patient then underwent urgent hemodialysis.Outcomes:The patient suffered gastrointestinal bleeding as a result of local caustic injury.In addition,his course of illness was complicated by severe acidemia from high anion gap metabolic acidosis and deranged electrolytes(hyperphosphatemia,hyperkalemia,and hypocalcemia).He developed multi-organ failure and eventually demised.Lessons:The clinician needs to be mindful of the multi-system complications arising from such a caustic ingestion.These patients need to be monitored closely for deterioration,and have prompt management of the various arising complications,to reduce the high morbidity and mortality associated with this condition.

关 键 词：Phosphoric acid poisoning Caustic ingestion Acid ingestion Cleaner ingestion Corrosive ingestion 

分 类 号：R595[医药卫生—内科学]