sodium-hypochlorite and Mediastinitis

A 16-year-old woman deliberately drank 4.5% sodium hypochlorite bleach. She was transferred to the emergency department after gastric lavage was performed at a local clinic. She experienced chest pain and fever after several vomiting episodes and esophagoscopy. Chest computerized tomography (CT) revealed air bubbles and abnormal soft tissue density at the right lateral aspect of the mid esophagus, a small amount of complicated pleural effusion, and pneumothorax. Barium esophagography revealed abnormal leakage of contrast media at the right wall of the mid esophagus, which indicated acute mediastinitis. The patient received intensive care and underwent delayed esophageal repair and colonic transplant. She was discharged 12 weeks after admission. Sodium hypochlorite is found in household bleaching agents used to disinfect dishes and bleach laundry. Poisoning due to ingestion of sodium hypochlorite bleach usually follows a benign clinical course. Few studies report severe complications such as esophageal stenosis or perforation.

Topics: Adolescent; Bleaching Agents; Esophageal Perforation; Female; Humans; Mediastinitis; Sodium Hypochlorite; Suicide, Attempted; Treatment Outcome

Treatment results in 61 patients with acute mediastinitis are analyzed. Combined treatment of acute mediastinitis, including cryoplasma-antienzymic complex use and indirect electrochemical blood plasma detoxication, promotes disappearance of microcirculation disorders, to earlier decreasing of endogenic intoxication, outcomes improvement.

Topics: Acute Disease; Adolescent; Adult; Aged; Combined Modality Therapy; Disinfectants; Electrochemistry; Female; Humans; Male; Mediastinitis; Middle Aged; Oxidants; Oxidation-Reduction; Physical Therapy Modalities; Plasmapheresis; Protease Inhibitors; Sodium Hypochlorite