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[Conservative treatment improved corrosive esophagitis and pneumomediastinum in a patient who ingested bleaching agent containing sodium hypochlorite and sodium hydroxide].

Abstract
A 69-year-old man was admitted to the emergency department 3 hours after ingestion of a bleaching agent containing hypochlorous acid and sodium hydroxide in a suicide attempt. Enhanced chest computed tomography scans taken on admission indicated an edematous esophagus and air bubbles in the mediastinum. He underwent endotracheal intubation and mechanical ventilation until day 9 because of laryngeal edema. On day 10, his endoscopy indicated diffuse reddish mucosal hyperemia, erosions, and lacerated mucosal lesions in the esophagus that were indicative of grade 2b corrosive esophagitis. Treatment with a proton pump inhibitor was initiated, with which the condition of the esophagus improved, and on day 44, a slight stricture of the upper part of the esophagus was observed. He was discharged on day 64 without any complaints. The ingestion of sodium hypochlorite induces corrosive esophagitis and acute phase of gastritis. Ingestion of any corrosive agent is known as a risk factor for esophagus cancer in the long-term. In such cases with esophageal stricture, esophagectomy is recommended for preventing esophagus cancer. Considering the age of the patient, however, he did not undergo esophagectomy.
AuthorsHiroshi Nakano, Ken Iseki, Akiko Ozawa, Aya Tominaga, Ryoichi Sadahiro, Koichi Otani
JournalChudoku kenkyu : Chudoku Kenkyukai jun kikanshi = The Japanese journal of toxicology (Chudoku Kenkyu) Vol. 27 Issue 1 Pg. 39-44 (Mar 2014) ISSN: 0914-3777 [Print] Japan
PMID24724360 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Bleaching Agents
  • Proton Pump Inhibitors
  • Sodium Hydroxide
  • Sodium Hypochlorite
Topics
  • Aged
  • Bleaching Agents (poisoning)
  • Esophagitis (chemically induced, diagnostic imaging, pathology, therapy)
  • Esophagoscopy
  • Esophagus (diagnostic imaging, pathology)
  • Humans
  • Intubation, Intratracheal
  • Male
  • Mediastinal Emphysema (chemically induced, diagnostic imaging, therapy)
  • Proton Pump Inhibitors (therapeutic use)
  • Respiration, Artificial
  • Sodium Hydroxide (poisoning)
  • Sodium Hypochlorite (poisoning)
  • Suicide, Attempted
  • Tomography, X-Ray Computed
  • Treatment Outcome

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