title: Death following injection sclerotherapy due to phenol toxicity.
abstract: Prolapse rectum (PR) or protrusion of the rectum beyond the anus occurs frequently in populations at both extremes of age. In the pediatric population, in developed countries, the commonest cause for PR is thought to be cystic fibrosis (CF). Treatment options for CF include conservative management, surgical resection and fixation, suturing, and injection sclerotherapy (IS). The last is considered an attractive treatment option because it is minimally invasive. In this case report, the authors present the details about a 2-year-old female child, with PR and CF, who died after IS, using phenol as the sclerotherapeutic agent. Autopsy findings and toxicology tests performed to establish phenol toxicity are documented. The available literature is reviewed. This case report underscores the risks of using phenol for IS and emphasizes the point that the procedure is not innocuous and an adverse outcome including fatality is a possibility.
authors: Onondaga County Medical Examiner's Office, 100 Elizabeth Blackwell Street, Syracuse, NY, USA. philipa@njdcj.org
authors: Abraham T
authors: AT
authors: Philip
authors: Jeanna M
authors: JM
authors: Marraffa
mesh_terms: D001929:Brain Edema / Q000473:pathology; D020520:Brain Infarction / Q000473:pathology; D002675:Child, Preschool; D003402:Creatine Kinase / Q000097:blood; D003550:Cystic Fibrosis / Q000150:complications; D004211:Disseminated Intravascular Coagulation / Q000139:chemically induced; D005234:Fatty Liver / Q000473:pathology; D005260:Female; D049429:Forensic Pathology; D006323:Heart Arrest / Q000139:chemically induced; D006470:Hemorrhage / Q000473:pathology; D006801:Humans; D002534:Hypoxia, Brain / Q000139:chemically induced; D008168:Lung / Q000473:pathology; D009206:Myocardium / Q000473:pathology; D019800:Phenol / Q000008:administration & dosage / Q000009:adverse effects* / Q000652:urine; D012005:Rectal Prolapse / Q000150:complications / Q000628:therapy*; D012206:Rhabdomyolysis / Q000139:chemically induced; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000009:adverse effects*; D015911:Sclerotherapy / Q000009:adverse effects*; D013154:Spleen / Q000473:pathology
chemical_list: D012597:Sclerosing Solutions; D019800:Phenol; D003402:Creatine Kinase