title: Acute abdomen as a consequence of an unusual suicide attempt: intra-abdominal injection of sulfuric acid.
abstract: Caustic ingestion is a common cause of life-threatening upper gastrointestinal tract injuries. It mostly happens in children as accidental exposure, but may occur in adults as a result of suicide attempt. We present a case of an acute abdomen that occurred after a peculiar way of self-administration of sulfuric acid as a suicide attempt in an adult psychiatric male patient, already known for self-harm with caustic agents in the previous years. In a few hours, the patient developed diffuse peritonitis, pneumoperitoneum, and a rapid hemodynamic deterioration, as a consequence of ileum and sigmoid necrosis, requiring an emergency surgery with the application of a damage control strategy. The patient was then transferred to intensive care unit for hemodynamic stabilization, and definitive surgical correction of the abdominal lesions was performed after 3 days with Hartmann procedure. Thirty-nine days after hospital admission, the patient was discharged. In conclusion, to our knowledge, never has been reported in the literature a case of intra-abdominal self-administration of caustic substance causing a rapid evolution of clinical conditions and requiring the application of damage control strategy.
authors.affiliation: Department of Anesthesia and Intensive Care, University of Foggia, Viale Pinto, Foggia.
authors.forename: Anna
authors.initials: A
authors.lastname: Lepore
authors.affiliation: Department of Anesthesia and Intensive Care, University of Foggia, Viale Pinto, Foggia.
authors.forename: Davide
authors.initials: D
authors.lastname: D'Antini
authors.affiliation: Department of Anesthesia and Intensive Care, "Santa Maria" Hospital, Via De Ferrariis, Bari, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Raimondo
authors.affiliation: Department of Anesthesia and Intensive Care, University of Foggia, Viale Pinto, Foggia.
authors.forename: Lucia
authors.initials: L
authors.lastname: Mirabella
authors.affiliation: Department of Anesthesia and Intensive Care, University of Foggia, Viale Pinto, Foggia.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Pennisi
authors.affiliation: Department of Anesthesia and Intensive Care, University of Foggia, Viale Pinto, Foggia.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Carrillo
authors.affiliation: Department of Anesthesia and Intensive Care, University of Foggia, Viale Pinto, Foggia.
authors.forename: Antonella
authors.initials: A
authors.lastname: Cotoia
authors.affiliation: Department of Anesthesia and Intensive Care, University of Foggia, Viale Pinto, Foggia.
authors.forename: Michele
authors.initials: M
authors.lastname: Dambrosio
authors.affiliation: Department of Anesthesia and Intensive Care, University of Foggia, Viale Pinto, Foggia.
authors.forename: Gilda
authors.initials: G
authors.lastname: Cinnella
keywords: abdomen; acute; attempted; caustics; laparotomy; peritonitis; suicide; sulfuric acid