title: Chest wall necrosis and empyema resulting from attempting suicide by injection of petroleum into the pleural cavity.
abstract: Hydrocarbon poisoning such as that of benzene and petroleum usually occurs accidentally by inhalation or ingestion of these cytotoxic chemical compounds. Intravenous or subcutaneous injection of petroleum compounds with intent of suicide or abuse is an extraordinary event that can result in local damage or systemic toxicity such as tissue necrosis, abscess formation, respiratory system failure and partial damage to the kidneys, the brain and the nervous system. In this article, we describe a 31-year-old man who was admitted in the surgery ward of Besat Hospital. He had widespread necrosis and infection of the chest wall soft tissue and also had empyema after a suicidal attempt by injection of 40 ml of petroleum into the left hemithorax. The patient underwent repeated surgical debridement of the chest wall necrotic tissues. With segmentectomy and flap reconstruction of the chest wall wound, he recovered completely and was discharged. Our report supports early and aggressive surgical debridement of necrotic tissue, thoracotomy tube insertion and special care of respiratory system toxicity after chest wall injection of petroleum. Regarding the basis of clinical findings and paraclinical investigations that measure lung parenchymal necrosis with empyema and fistula formation, thoracotomy and decortication with or without lung tissue resection and also chest wall reconstruction are the standard treatment of these patients.
authors.affiliation: Department of Surgery, School of Medicine, Hamedan University of Medical Sciences and Health Services, 105 Saeedieh Street, Hamedan, Iran. dreskandarlou_m@yahoo.com
authors.forename: M
authors.initials: M
authors.lastname: Eskandarlou
authors.forename: A H
authors.initials: AH
authors.lastname: Moaddab
mesh_terms: D000328:Adult; D004653:Empyema / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D009336:Necrosis; D010578:Petroleum / Q000506:poisoning*; D035422:Pleural Cavity / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography; D013406:Suicide, Attempted; D035441:Thoracic Wall / Q000473:pathology*
chemical_list: D010578:Petroleum