Highly Concentrated Acetic Acid Poisoning: 400 Cases Reviewed

Background: Caustic substance ingestion is known for causing a wide array of gastrointestinal and systemic complications. In Russia, ingestion of acetic acid is a major problem which annually affects 11.2 per 100,000 individuals. The objective of this study was to report and analyze main complications and outcomes of patients with 70% concentrated acetic acid poisoning. Methods: This was a retrospective study of patients with acetic acid ingestion who were treated at Sverdlovsk Regional Poisoning Treatment Center during 2006 to 2012. GI mucosal injury of each patient was assessed with endoscopy according to Zargar’s scale. Data analysis was performed to analyze the predictors of stricture formation and mortality. Results: A total of 400 patients with median age of 47 yr were included. GI injury grade I was found in 66 cases (16.5%), IIa in 117 (29.3%), IIb in 120 (30%), IIIa in 27 (16.7%) and IIIb in 70 (17.5%). 11% of patients developed strictures and overall mortality rate was 21%. Main complications were hemolysis (55%), renal injury (35%), pneumonia (27%) and bleeding during the first 3 days (27%). Predictors of mortality were age 60 to 79 years, grade IIIa and IIIb of GI injury, pneumonia, stages I , F and L of kidney damage according to the RIFLE scale and administration of prednisolone. Predictors of stricture formation were ingestion of over 100 mL of acetic acid and grade IIb and IIIa of GI injury. Conclusion: Highly concentrated acetic acid is still frequently ingested in Russia with a high mortality rate. Patients with higher grades of GI injury, pneumonia, renal injury and higher amount of acid ingested should be more carefully monitored as they are more susceptible to develop fatal consequences. 

Highly Concentrated Acetic Acid Poisoning: 400 Cases Reviewed Keywords:

Poisoning , Acetic acid , Gastrointestinal injury , Stricture , Mortality