title: Esophageal perforation and mediastinitis after suicidal ingestion of 4.5% sodium hypochlorite [correction of hydrochlorite] bleach.
abstract: A 16-year-old woman deliberately drank 4.5% sodium hypochlorite bleach. She was transferred to the emergency department after gastric lavage was performed at a local clinic. She experienced chest pain and fever after several vomiting episodes and esophagoscopy. Chest computerized tomography (CT) revealed air bubbles and abnormal soft tissue density at the right lateral aspect of the mid esophagus, a small amount of complicated pleural effusion, and pneumothorax. Barium esophagography revealed abnormal leakage of contrast media at the right wall of the mid esophagus, which indicated acute mediastinitis. The patient received intensive care and underwent delayed esophageal repair and colonic transplant. She was discharged 12 weeks after admission.   Sodium hypochlorite is found in household bleaching agents used to disinfect dishes and bleach laundry. Poisoning due to ingestion of sodium hypochlorite bleach usually follows a benign clinical course. Few studies report severe complications such as esophageal stenosis or perforation.
authors.affiliation: Department of Emergency Medicine, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea.
authors.forename: Jung Soo
authors.initials: JS
authors.lastname: Park
authors.forename: Jin Hong
authors.initials: JH
authors.lastname: Min
authors.forename: Hoon
authors.initials: H
authors.lastname: Kim
authors.forename: Suk Woo
authors.initials: SW
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D057886:Bleaching Agents / Q000506:poisoning*; D004939:Esophageal Perforation / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D008480:Mediastinitis / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D012973:Sodium Hypochlorite / Q000506:poisoning*; D013406:Suicide, Attempted; D016896:Treatment Outcome
chemical_list: D057886:Bleaching Agents; D012973:Sodium Hypochlorite