title: White phosphorus poisoning by oral ingestion of firecrackers or little devils: current experience in Ecuador.
abstract: BACKGROUND
  White phosphorus (WP) is widely used illicitly in fireworks in South America. We report our experience in seven Ecuadorian hospitals.
  
  
  METHODS
  A cross-sectional study of patients presented during 2009. Inclusion criteria included: reported oral ingestion of firecrackers (little devils) in any age. Data were gathered using inpatient records and a written survey of the victims.
  
  
  RESULTS
  The mean age of the patients was 21.6+/-7.1 years (women 63.5%); 64.7% of cases occurred in November, December and January. In 46% of cases, the number of units ingested was between 1 and 5 (~0.3 to 1.5 g WP), maximum 40 (~12 g). Forty-seven cases attended within 12 hours (55.3%); 5.9% died and 2.4% were readmitted. The remainder were eventually discharged well. Clinical features included: abdominal pain, cramps, diarrhoea, jaundice, nausea and vomiting, abnormal liver enzymes, and coagulation times and hypoglycaemia.
  
  
  CONCLUSIONS
  The typical case was an adolescent woman between 16 and 19 years with self-harm around Christmas. There was no specific treatment, but early attendance was associated with improved prognosis. Further studies are necessary to establish an adequate protocol of treatment.
authors.affiliation: School of Medicine, Faculty of Medical Sciences, Central University of Ecuador, Quito, Ecuador. fabriciogonzaleza@yahoo.es
authors.forename: Fabricio
authors.initials: F
authors.lastname: González-Andrade
authors.forename: Ramiro
authors.initials: R
authors.lastname: López-Pulles
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D004484:Ecuador; D053834:Explosive Agents / Q000506:poisoning*; D005260:Female; D006801:Humans; D008297:Male; D017553:Phosphorus Compounds / Q000506:poisoning*; D055815:Young Adult
chemical_list: D053834:Explosive Agents; D017553:Phosphorus Compounds