Hydrogen peroxide ingestion with injury to upper gastrointestinal tract

Abstract

Hydrogen peroxide is a common over-the-counter solution that has developed a growing body of literature regarding toxic ingestion. Intentional ingestion of high concentration hydrogen peroxide for health purposes has gained popularity in certain patient populations; purported benefits are due to the increased oxygen released into the blood stream. We present for evaluation one such case with associated imaging that presented to our urban medical center. A brief review of the literature was also performed noting current recommendations regarding both outcomes and indications for endoscopy as well as hyperbaric oxygen therapy following ingestion of hydrogen peroxide. Our patient was a 51-year-old white female who presented with foamy hematemesis after ingesting 10 drops of 35% hydrogen peroxide as part of a home remedy to cleanse her colon and improve blood oxygenation. In addition to hematemesis, she also reported diffuse abdominal pain with sore throat and hoarse voice. Her imaging demonstrated portal venous gas and gastric edema. She was admitted for hyperbaric oxygen therapy and underwent upper endoscopy demonstrating diffuse esophagitis and gastritis with white exudate and multiple petechiae. She was later discharged home in stable condition and was lost to follow-up.

Hepatic Portal Venous Gas (HPVG) after Ingestion of Chlorine Bleach: A Transient Phenomenon

“…Hyperbaric oxygen (HBO) therapy is suggested as a prudent measure by many authors to prevent the further progression of gas emboli, and it should be considered in the presence of neurological symptoms. The choice to initiate this treatment should be based on a thoughtful evaluation of the accessibility of suitable services and a careful assessment of the treatment's potential advantages and disadvantages [18,19].…”

Hydrogen peroxide is a risk factor for occupational chemical poisoning

“…Hydrogen peroxide poisoning causes brain infarction, and ingestion of hydrogen peroxide injures the upper gastrointestinal tract. [ 1 ] Besides, food poisoning is often caused due to hydrogen peroxide. A case has been reported in China that cerebral embolism was caused by oral hydrogen peroxide poisoning.…”

Gastric antrum stenosis caused by accidental ingestion of concentrated hydrogen peroxide

“…5 Complications such as gastritis, hemorrhagic gastritis, gastric ulcers, and gas in the portal vein have also been reported. [1][2][3] Accidental ingestion of concentrated HP (35%) is more likely to result in serious complications such as hemorrhagic gastritis, portal venous gas embolism, acute myocardial infarction, neurological impairment, and death. 1,4,[6][7][8] Our patient presented with a rare case of accidental ingestion of HP associated with the portal vein gas embolism, gastritis, and gastric antrum stenosis, which hindered the patient's intake of food and resulted in malnutrition.…”

“…However, its routine use is limited by many toxic effects such as portal gas embolism 1 and proctitis. 2 Accidental ingestion of concentrated HP is not common and has been reported to cause an extensive portal gas embolism, esophagitis, gastritis, 3 and even result in death. However, reports of gastric corpus stenosis caused by accidental ingestion of HP are rare.…”

“… 5 Complications such as gastritis, hemorrhagic gastritis, gastric ulcers, and gas in the portal vein have also been reported. 1 , 2 , 3 Accidental ingestion of concentrated HP (35%) is more likely to result in serious complications such as hemorrhagic gastritis, portal venous gas embolism, acute myocardial infarction, neurological impairment, and death. 1 , 4 , 6 , 7 , 8 …”