Deaths due to corrosive ingestion: a 10-year retrospective study

Severe Intentional Corrosive (Nitric Acid) Acute Poisoning: A Case Report and Literature Review

Despite being one of the most debilitating conditions encountered in the field of toxicology, there is a lack of neutralization measures for the toxins involved in acute corrosive poisoning, and this promotes progressive contact injury of deep tissues after poisoning has occurred. Multiple controversies still surround management strategies during the acute phase of poisoning and the long-term follow-up of the patient. Here, we report a severe case of intentional poisoning with nitric acid complicated by extensive injury of the upper digestive tract, multiple stricture formation, and complete dysphagia. Serial endoscopic dilation and insertion of a jejunostomy feeding tube were necessary, and underlying psychiatric illness negatively affected the outcome of the patient. We conclude that an interdisciplinary approach is necessary to properly reduce the extent of lesions and sequelae induced by corrosion. Early endoscopic mapping of injuries is of major importance to better predict the evolution and possible complications of poisoning. Interventional and reconstructive surgical procedures may significantly improve the life expectancy and quality of life of patients following intoxication with corrosive substances.

Fatal corrosive ingestion: A study from South and South-East Delhi, India (2005-2014)

The study presents a retrospective analysis of 64 cases of death resulting from ingestion of corrosive substances. The cases represented approximately 0.4% of all autopsies conducted and 13.6% of all fatal poisonings studied during the 10-year period from January 2005 to December 2014 at the Department of Forensic Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi. The data was analyzed with regard to age, sex, nature and source of corrosive substance used, survival period, cause and manner of death. Males (64.06%) outnumbered females (35.94%), with a male-to-female ratio of 1.78:1. The most common age group involved was 21-30 years (35.94%). Sulfuric acid (68.75%) presented as the most common corrosive substance ingested. Household cleaning substances (39.06%) were identified as a common source of such type of corrosive substance, but the exact source could not be identified in 56.26% of cases. In the majority of cases (46.88%) death was due to perforation peritonitis. Most of the victims (54.69%) succumbed to their injuries within a day of ingestion. In 87.5% of cases, the corrosive substance was consumed for suicidal purposes. A strict regulatory framework is required for the production, distribution, storage and use of corrosive substances. Preventive guidelines and creating awareness among the masses will go a long way towards curbing such unfortunate incidents.