A Case of Chemical Injury due to Dichloromethane SuccessfullyTreated by Early Decontamination and Hyperbaric Oxygen Therapy

Abstract

 The patient was a 45-year-old male. He was transferred to the emergency room after losing consciousness while using a dichloromethane-based paint stripper in a poorly ventilated room. At the time of transport, in addition to impaired consciousness, 7% of the total burn area was found to be partial thickness burns (left elbow 2%, abdomen 2%, right forearm 1%, left thigh 2%) . An elevated blood carboxyhemoglobin level was also observed. He was diagnosed with acute poisoning with chemical burns caused by dichloromethane. Decontamination was performed immediately, and high-concentration oxygen administration was continued after hospitalization, but the blood carboxyhemoglobin level in the blood increased, and the disturbance of consciousness was prolonged. Hyperbaric oxygen therapy was started the day after the injury, and the blood carboxyhemoglobin level promptly decreased and the disturbance in consciousness improved. The burn wound did not deepen and healed within 3 weeks after the injury with topical medication application. Dichloromethane can cause chemical injury due to its local irritant and degreasing effects, as well as impaired consciousness on its own and due to carbon monoxide produced by its metabolism. Early decontamination and hyperbaric oxygen therapy were useful in this case.