title: [A case of disseminated intravascular coagulopathy (DIC) and multiple organ failure (MOF) after ingestion of hydrochloric acid].
abstract: Ingestion of caustic materials causes systemic damages and requires treatment in an intensive care unit. This report presents a case of disseminated intravascular coagulopathy (DIC) and multiple organ failure after ingestion of hydrochloric acid in an attempted suicide. The patient was admitted to the emergency ward within 1 hr after ingestion of 60 ml of 35% hydrochloric acid. Initial blood examination suggested hemolysis without anemia or thrombocytopenia. Arterial blood gas analysis exhibited evident metabolic acidosis with hypoxia. Two hours after ingestion, severe hemolysis, anemia, thrombocytopenia emerged with abnormal results from clotting and fiblinolysis tests, and a diagnosis of DIC was made. Subsequently, conjugate deviation and severe bleeding diathesis appeared. No evidence for gastrointestinal bleeding and brain hemorrhage was obtained in our abdominal echography and brain computed tomography, respectively. In spite of vigorous suppurative therapy including transfusion of blood, fresh frozen plasma, and catecholamines, the patient expired 29 hrs after ingestion. Autopsy was not carried out. Rapid progressive DIC as an acute complication of acid ingestion must be born in mind.
authors.affiliation: Department of Emergency and Critical Care Medical Center, Ogaki Municipal Hospital.
authors.forename: Y
authors.initials: Y
authors.lastname: Niki
authors.forename: K
authors.initials: K
authors.lastname: Minakuchi
authors.forename: A
authors.initials: A
authors.lastname: Takasu
authors.forename: T
authors.initials: T
authors.lastname: Nakamura
authors.forename: S
authors.initials: S
authors.lastname: Inada
authors.forename: F
authors.initials: F
authors.lastname: Yamazaki
authors.forename: H
authors.initials: H
authors.lastname: Mori
mesh_terms: D000138:Acidosis / Q000139:chemically induced; D000328:Adult; D004211:Disseminated Intravascular Coagulation / Q000139:chemically induced*; D005260:Female; D006801:Humans; D006851:Hydrochloric Acid; D009102:Multiple Organ Failure / Q000139:chemically induced*; D013405:Suicide
chemical_list: D006851:Hydrochloric Acid