alkali ingestion

INTRODUCTION: Caustic agents, also called corrosive agents, could be acids or alkali in nature. If ingested, these agents can injure any part of the aerodigestive tree. Extent of injury depends on the type, concentration, duration of exposure and volume of caustic agent ingested. Serious complications after caustic agent ingestion can occur both in the short term such as hollow viscus perforation and death and in the long term such as stricture formation causing obstruction and lifetime risk of development of carcinoma...

Metabolic alkalosis is a widespread acid-base disturbance, especially in hospitalized patients. It is characterized by the primary elevation of serum bicarbonate and arterial pH, along with a compensatory increase in Pco2 consequent to adaptive hypoventilation. The pathogenesis of metabolic alkalosis involves either a loss of fixed acid or a net accumulation of bicarbonate within the extracellular fluid. The loss of acid may be via the gastrointestinal tract or the kidney, whereas the sources of excess alkali may be via oral or parenteral alkali intake...

Calcium regulation is tightly controlled in the body. Multiple causes of hypercalcemia have been studied including primary hyperparathyroidism, hypercalcemia of malignancy, and chronic granulomatous disorders. Among the less studied causes is calcium-alkali syndrome. Here, we discuss a case of hypercalcemia secondary to calcium-alkali syndrome, presenting with hypercalcemia, metabolic alkalosis, and acute kidney injury as a result of ingestion of a large amount of calcium supplements. Hypercalcemia can result in impaired collecting duct system sensitivity to antidiuretic hormone, afferent arteriole constriction, and activation of calcium sensor receptors in multiple tissues...

A 13 year old male was referred to the Department of Otorhinolaryngology due to unsuccessful decannulation. At 2 years of age, patient accidentally ingested a caustic liquid alkali and underwent emergency tracheostomy, exploratory laparotomy, and tube gastrectomy. 11 years after, patient was seen at the outpatient department for decannulation. On nasopharyngolaryngoscopy, a supraglottic stenosis with a central 1-mm opening was visualized. Patient underwent transoral carbon dioxide laser excision of supraglottic stenosis...

Milk-alkali syndrome (MAS) is one of the causes of hypercalcaemia. We report a case of a 75-year-old lady with a history of thyroidectomy, presented with an altered mental state and had an extremely high calcium concentration of 4.96mmol/L. The hypercalcemia was attributed to the ingestion of large doses of calcium supplements, including calcium carbonate and calcium lactate, leading to MAS. She was managed with intravenous fluids, diuretics and withdrawal of calcium supplements. The patient responded well to treatment and regained consciousness...

Severe metabolic alkalosis is rarely seen in end stage renal disease (ESRD) patients on long-term hemodialysis. This can be life threatening and mortality is exponentially increased when the pH exceeds 7.60. Persistent vomiting, ingestion of alkali for dyspepsia and pica behavior are all potential causes of such severe metabolic alkalosis. The prevalence of pica is increased in chronic kidney disease and ESRD patients, with ice being the most commonly ingested substance. It can cause a myriad of complications including death, but the diagnosis may be elusive unless the pica behavior is witnessed firsthand by others since patients do not typically disclose their behavior...

Children constitute 80% of all corrosive ingestion cases. The majority of this burden is contributed by developing countries. Accidental ingestion is common in younger children (< 5 years) while suicidal ingestion is more common in adolescents. The severity of injury depends on nature of corrosive (alkali or acid), pH, amount of ingestion and site of exposure. There are multiple doubts and dilemmas which exist in management of both acute ingestion and chronic complications. Acute ingestion leads to skin, respiratory tract or upper gastrointestinal damage which may range from trivial to life threatening complications...

Melena neonatorum is not uncommon; it presents as bloody stool in newborns and is caused by ingestion of maternal blood. This case presents an infant who had multiple episodes of copious amount of blood in his stool starting at 10 min of life, which raised multiple concerns requiring further investigation. The alkali denaturation test confirmed that the blood was maternal; however, due to the amount of bloody stool and the time required for the alkali denaturation test to result, further workups such as abdominal radiograph and hemoglobin/hematocrit were completed to ensure nothing was overlooked...

Hydrogeochemical and Health Risk Assessments of trace elements are integral to groundwater resource assessment, utilization, and human health. Investigation of groundwater chemistry and trace elemental impact on local inhabitants were attempted in Shanmuganadhi basin, Tamilnadu, India. About 60 groundwater samples were collected during the pre-monsoon period and analyzed for hydrochemical composition, including major and trace elements (Fe, Cr, Ni, Cu Pb, Mn, and As) to isolate chemical characteristics and human health risk assessment...

BACKGROUND: Gastric conduit has emerged as the preferred treatment option for both esophageal bypass and replacement for corrosive stricture of the esophagus. There is a lack of consensus and a dearth of published literature regarding the short- and long-term complications of using a gastric conduit. This meta-analysis aims to evaluate the outcomes, morbidity, and complications associated with it. METHODS: MEDLINE, Cochrane Library, and Google Scholar (January 1960 to May 2020) were systematically searched for all studies reporting short- and/or long-term outcomes and complications following the use of a gastric conduit for corrosive esophageal stricture...

BACKGROUND: Ingestion of alkaline fluids is a common problem, which can lead to perforations, strictures and malignancy. We present a rare case series of several patients who accidentally ingested the same alkaline substance in different doses. METHODS: We investigated four patients with accidental ingestion of dishwashing liquid. All patients underwent gastroscopy within 24h after inpatient admission. Gastroesophageal lesions were classified according to the Zargar classification for corrosive ingestions...

BACKGROUND AND AIM: Corrosive ingestion causes significant morbidity in children with no standard guidelines regarding management. This survey aimed to understand practices adopted by gastroenterologists, identify lacunae in evaluation and management and suggest a practical algorithm. METHODS: Indian gastroenterologists participated in an online survey (65 questions) on managing corrosive ingestion. When ≥ 50% of respondents agreed on a management option, it was considered as 'agreement'...

Purpose : To report a case of Purtscher-like retinopathy secondary to acute pancreatitis caused by medication-induced calcium-alkali syndrome in a pregnant woman. Methods : Case report Results : A 39-year-old 23-week pregnant patient complained of visual disturbances during admission for acute pancreatitis precipitated by calcium-alkali syndrome. History revealed the acute ingestion of over 2,400 mg of elemental calcium from over the counter medication in the background of longstanding use. Visual acuity was counting fingers at 1 foot bilaterally...

Milk-alkali syndrome or calcium-alkali syndrome (CAS) is the triad of hypercalcemia, metabolic alkalosis and renal impairment. It is often related to ingestion of high amounts of calcium carbonate, which was used historically for the treatment of peptic ulcer disease. The incidence of the syndrome decreased dramatically after the introduction of newer peptic ulcer medications such as proton pump inhibitors and histamine blocking agents. However, a resurgence was seen in the late 1980s with the wide use of over-the-counter calcium supplements, mainly by females for osteoporosis prophylaxis...

Among the pertinent differentials for hypercalcemia, milk-alkali syndrome remains a diagnosis of exclusion following a thorough workup of other severe causes. However, several key signs may increase a clinician's index of suspicion for possible milk-alkali syndrome, including a prolonged history of antacid ingestion. Milk-alkali syndrome commonly presents with a classic triad: hypercalcemia, metabolic alkalosis, and acute kidney injury. The diagnostic workup should include evaluation of both serum and urine calcium levels, serum phosphate levels, and other hormones (parathyroid hormone, vitamin D)...

Mushroom polysaccharides have been revered for decades as incredibly versatile compounds suitable for application in biomedical, pharmaceutical, food, and cosmetic industries. In that essence Russula alatoreticula, a traditionally appraised unique macrofungus, has earlier been explored to contain functional macromolecules elicited by hydrothermal and cold alkali systems. Remnants of that multistep extraction could further be utilized not only to isolate high-value components, but also to reduce waste material...

BACKGROUND AND STUDY AIMS: Esophageal burns due to ingestion of corrosive substances are frequently seen in both children and adults. However, there is no standard method of treatment to prevent associated mortality and morbidity. Therefore, this study aimed to evaluate the effects of known antioxidants, namely N-acetyl cysteine and ethyl pyruvate, on esophageal damage due to sodium hydroxide-induced corrosive burns. MATERIALS AND METHODS: Thirty-five female rats were randomly assigned to five equal groups...

INTRODUCTION: caustic ingestion in children is rare but has potentially serious consequences. AIM: to analyze the clinical and endoscopic features and the type of caustic ingested in our population. METHODS: the upper endoscopies performed in this setting, as well as the characteristics of patients and caustics, were analyzed from 2010 to 2018. RESULTS: fifty-one endoscopies were performed (48 cases of witnessed intake or high suspicion and three with a low suspicion) in patients with a mean age of 2...

Background Caustic ingestion continues to be a significant problem worldwide especially in developing countries and particularly in the age group of under six years. Ingestion of caustic substances is a medical emergency in both the adult and pediatric population and is associated with high morbidity and mortality. The ingestion of caustic substances induces an extensive spectrum of injuries to the aerodigestive tract, which includes extensive necrosis and perforation of the esophagus and stomach. Objectives The main aims were to determine upper and lower esophageal injuries associated with corrosive intake and to compare esophageal injury with age and gender...

INTRODUCTION: Caustic substance ingestion is frequently life-threatening, and its pathological mechanisms of tissue damage are well documented. However, few studies have assessed the combined effects of pH and the ingested dose on patient outcomes. Additionally, the miscellaneous chemical properties are not immediately available for providing predictive insights to physicians. This study aimed to provide a new perspective of the risk assessment of caustic substance ingestion based on the pH and dose...