Acute liver failure due to white phosphorus ingestion.
BACKGROUND
White phosphorus is chemical compound available in military ammunition as well as in explosive powder of recreational use. This latter form is commonly found in Latin America and Asia as a main ingredient of gunpowder used to make street firecrackers. Small firecrackers may be ingested accidentally or used as a toxic agent in suicidal attempts which may cause of acute liver failure and death; however the clinical features, incidence and outcome are poorly described in the literature.


METHODS
We describe three cases of white phosphorus intoxication with acute liver failure secondary to the consumption of firecrackers. In two cases, ingestion occurred secondary to suicidal attempts and in one, ingestion occurred by accident. In one case, liver injury improved with supportive care, in the other, the patient required liver transplantation and the third case had a fatal outcome.


CONCLUSIONS
Clinicians providing care of patients with acute hepatitis of unclear etiology should be aware that the ingestion of firecrackers containing white phosphorus might cause acute liver failure that may require liver transplantation.
Santos
Oscar
O
Division of Internal Medicine, Gastroenterology and Hepatology, Hospital Pablo Tobón Uribe.
Restrepo
Juan-Carlos
JC
Velásquez
Lina
L
Castaño
Jaime
J
Correa
Gonzalo
G
Sepúlveda
Elsy
E
Yepes
Nora
N
Hoyos
Sergio
S
Guzmán
Carlos
C
Osorio
Germán
G
Cárdenas
Andrés
A
D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D003131:Combined Modality Therapy; D062787:Drug Overdose; D053834:Explosive Agents / Q000506:poisoning*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000139:chemically induced* / Q000473:pathology / Q000628:therapy; D016031:Liver Transplantation; D008297:Male; D017553:Phosphorus Compounds / Q000506:poisoning*; D013406:Suicide, Attempted; D016896:Treatment Outcome
D053834:Explosive Agents; D017553:Phosphorus Compounds