Журнал клинической токсикологии
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Management of Acid Toilet Bowl Detergent-Induced Chemical Injuries

Tatsuma Fukuda, Tatsuya Sato, Naoko Ohashi, Naoki Hayase, Masataka Gunshin, Takehiro Matsubara, Takeshi Ishii, Susumu Nakajima and Naoki Yahagi

The main component of acid toilet bowl detergents used in Japan is 9.5% hydrochloric acid and cationic surfactant. Similar toilet bowl detergents are sold worldwide, and they are easily available. However, if taken in the wrong way, they prove very harmful, even a small amount. There is no specific therapy in cases of ingestion of acid toilet bowl detergent. Therefore, symptomatic treatment and general management such as controlling breathing and circulation are provided for the patient. Here, we presented a 75-year-old man attempted suicide by ingesting a large amount of acid toilet bowl detergents. In this case, we could diagnose in acute phase with careful questioning and the emergency crew activity at the scene of the accident. On the basis of the diagnosis, we provided symptomatic treatment and general management, but we were necessary for a treatment for a very long term. It was difficult to establish enteral nutrition due to chemical injury to digestive tract. That might be one of the causes of repeated infections such as bacterial translocation. The possibility of a temporary enterostomy should have been considered to establish early nutrition as part of intensive care.