Write your message
Volume 11, Issue 3 (May-June 2017)                   IJT 2017, 11(3): 7-10 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Ghoochani Khorasani A, Erfantalab P, Rezai M. Predictive Factors of Gastrointestinal Injuries after Exposure to Sodium Hypochlorite. IJT. 2017; 11 (3) :7-10
URL: http://ijt.arakmu.ac.ir/article-1-542-en.html
1- Department of Medical Sciences, Amin Police University, Tehran, Iran.
2- Fellowship in Clinical Toxicology, Emergency Medicine Management Research Center, Rasoul-e-Akram Hospital, Iran university of Medical Sciences, Tehran, Iran. , peyman_erfan@yahoo.com
3- MD. Emergency medicine management Research center, Rasoul-e-Akram Hospital, Iran university of Medical Sciences, Tehran, Iran.
Abstract:   (2431 Views)

Background: Sodium hypochlorite is found in bleaching agents used to cleaning dishes and bleach laundry. The ingestion of sodium hypochlorite causes acute corrosive esophagitis and gastritis. In establishing the diagnosis and therapeutic approach of acute corrosive poisonings, the upper endoscopy has great importance. The aim of this study was to determine predictive factors of gastrointestinal injuries that mandate early endoscopy.

Methods: This study consisted of 65 patients presented to Loghman Hakim Toxicology Center, Tehran, Iran with history of sodium hypochlorite bleach exposure from 2010 to 2014. The post-corrosive damage classified according to Kikendal’s grading.

Results: There were a total of 19 males and 46 females with a mean age of 34.21 yr old. In upper GI endoscopy, 20% of poisoned patients had abnormal findings. Male gender (P=0.029), presence of hoarseness (P=0.044), nausea and vomiting (P=0.007), sialorrhea (P=0.044) and higher age (P=0.05) were associated with the occurrence of gastrointestinal injuries, but only male gender (OR=5.04), nausea and vomiting (OR=8.97) were independent predictors of gastrointestinal injuries (P=0.03 and P=0.03, respectively).

Conclusion: We proposed five factors associated with gastrointestinal injuries, which could be important factors that mandate urgent endoscopy.

Full-Text [PDF 41 kb]   (1081 Downloads)    
Type of Study: Applicable | Subject: General

1. Park JS, Min JH, Kim H, Lee SW. Esophageal perforation and mediastinitis after suicidal ingestion of 4.5% sodium hydrochlorite bleach. Clin Toxicol 2011;49(8):765-6. [DOI:10.3109/15563650.2011.607168]
2. Racioppi F, Daskaleros P, Besbelli N, Borges A, Deraemaeker C, Magalini S, et al. Household bleaches based on sodium hypochlorite: review of acute toxicology and poison control center experience. Food Chem Toxicol 1994;32(9):845-61. [DOI:10.1016/0278-6915(94)90162-7]
3. Motta M, Chaves‐Mendonca M, Stirton C, Cardozo H. Accidental injection with sodium hypochlorite: report of a case. Int Endod J 2009;42(2):175-82. [DOI:10.1111/j.1365-2591.2008.01493.x]
4. Rich S, Slots J, editors. Sodium hypochlorite (dilute chlorine bleach) oral rinse in patient self-care. J West Soc Periodontol Periodontal Abstr 2014; 63(4):99-104.
5. Ross M, Spiller H. Fatal ingestion of sodium hypochlorite bleach with associated hypernatremia and hyperchloremic metabolic acidosis. Vet Hum Toxicol 1999;41(2):82-6.
6. Froner GA, Rutherford GW, Rokeach M. Injection of sodium hypochlorite by intravenous drug users. JAMA. 1987;258(3):325-6. [DOI:10.1001/jama.258.3.325]
7. Morgan DL. Intravenous injection of household bleach. Ann Emerg Med 1992;21(11):1394-5. [DOI:10.1016/S0196-0644(05)81909-2]
8. Bruch M. Toxicity and safety of topical sodium hypochlorite. Disinfection by Sodium Hypochlorite: Dialysis Applications: Karger Publishers; 2006. p. 24-38. [DOI:10.1159/000096812]
9. Arévalo‐Silva C, Eliashar R, Wohlgelernter J, Elidan J, Gross M. Ingestion of caustic substances: a 15‐year experience. The Laryngoscope 2006;116(8):1422-6. [DOI:10.1097/01.mlg.0000225376.83670.4d]
10. Gharib B, Mohammadpour M, Yaghmaie B, Sharifzadeh M, Mehdizadeh M, Zamani F, et al. Caustic agent ingestion by a 1.5-year-old boy. Acta Med Iran 2016;54(7):465-70.
11. Ward M, Routledge P. Hypernatraemia and hyperchloraemic acidosis after bleach ingestion. Hum Exp Toxicol 1988;7(1):37-8. [DOI:10.1177/096032718800700108]
12. Kikendall J. Caustic ingestion injuries. Clin Gastroenterol 1991;20(4):847-57.
13. Peck B, Workeneh B, Kadikoy H, Patel SJ, Abdellatif A. Spectrum of sodium hypochlorite toxicity in man-also a concern for nephrologists. NDT plus. 2011;4(4):231-5. [DOI:10.1093/ndtplus/sfr053]
14. Farook S, Shah V, Lenouvel D, Sheikh O, Sadiq Z, Cascarini L. Guidelines for management of sodium hypochlorite extrusion injuries. Br Dent J 2014;217(12):679-84. [DOI:10.1038/sj.bdj.2014.1099]
15. Verma A, Vanguri VK, Golla V, Rhyee S, Trainor M, Abramov K. Acute kidney injury due to intravenous bleach injection. J Med Toxicol 2013;9(1):71-4. [DOI:10.1007/s13181-012-0259-6]
16. Nakano H, Iseki K, Ozawa A, Tominaga A, Sadahiro R, Otani K. Conservative treatment improved corrosive esophagitis and pneumomediastinum in a patient who ingested bleaching agent containing sodium hypochlorite and sodium hydroxide. Chudoku kenkyu 2014;27(1):39-44.
17. Hifumi T, Yoshioka H, Kanemura T, Kiriu N, Hasegawa E, Kato H, et al. Case of alkaline esophagitis due to sodium hypochlorite ingestion. Chudoku kenkyu 2010;23(4):293-6.
18. Satar S, Topal M, Kozaci N. Ingestion of caustic substances by adults. Am J Ther 2004;11(4):258-61. [DOI:10.1097/01.mjt.0000104487.93653.a2]
19. Cardona J, Boussemart T, Berthier M, Oriot D. Accidental bleach ingestion in children: results of a survey in 11 anti-poison centres. Proposals for management. Pediatrie 1993; 48(10):705-9.
20. Sawalha AF. Storage and utilization patterns of cleaning products in the home: toxicity implications. Accid Anal Prev 2007;39(6):1186-91. [DOI:10.1016/j.aap.2007.03.007]

Add your comments about this article : Your username or Email:

Send email to the article author

© 2020 All Rights Reserved | Iranian Journal of Toxicology

Designed & Developed by : Yektaweb