Abstract
A case of acetic acid poisoning is reported. A 59-year-old man ingested about 100ml of 30% acetic acid to commit suicide. He, suffering from acute abdominal pain, vomiting and marked hemoglobinuria, was brought to the emergency department of our hospital within a half hour or so and transferred to the ICU on the following day because of anuria, respiratory insufficiency, disseminated intravascular coagulation (DIC), and circulatory shock. We started mechanical ventilation and continuous hemodiafiltration (CHDF) and administered heparin, antithrombin III, gabexate mesilate, fresh frozen plasma, and concentrated platelets for DIC. An endoscopic examination of upper digestive system revealed corrosive injury in esophagus and stomach. The patient gradually restored his organ function and was weaned from CHDF in one month and from mechanical ventilation in two, however, stayed in the ICU for about three months because of prolonged intestinal bleeding. He received a total of 290 units of erythrocytes and 468 units of fresh frozen plasma. Acetic acid ingestion causes not only topical injury in upper digestive tract but also injury in systemic organs including hemolysis, DIC, renal and hepatic dysfunction, shock to culminate a patient in multiple organ failure. A strict monitoring and treatment are essential during the acute phase of acetic acid poisoning.
