Hydrogen peroxide ingestion associated with portal venousgas and treatment with hyperbaric oxygen: A case seriesand review of the literature

Loren Keith French, B. Zane Horowitz, Nathanael J. McKeown

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Introduction.Ingestion of concentrated hydrogen peroxide (H2O2) has been associated with venous and arterial gas embolic events, hemorrhagic gastritis, gastrointestinal bleeding, shock, and death. Although H 2O2 is generally considered a benign ingestion in low concentrations, case reports have described serious toxicity following high concentration exposures. Hyperbaric oxygen (HBO) has been used with success in managing patients suffering from gas embolism with and without manifestations of ischemia.Methods.Poison center records were searched from July 1999 to January 2010 for patients with H2O2 exposure and HBO treatment. Cases were reviewed for the concentration of H2O2, symptoms, CT scan findings of portal gas embolism, HBO treatment, and outcome.Results.Eleven cases of portal gas embolism were found. Ages ranged from 4 to 89 years. All but one ingestion was accidental in nature. In 10 cases 35 H2O2 was ingested and in 1 case 12 H2O 2 was ingested. All abdominal CT scans demonstrated portal venous gas embolism in all cases. Hyperbaric treatment was successful in completely resolving all portal venous gas bubbles in nine patients (80) and nearly resolving them in two others. Ten patients were able to be discharged home within 1 day, and one patient had a 3.5-day length of stay.Conclusions.HBO was successful in resolving portal venous gas embolism from accidental concentrated H2O2 ingestions.

Original languageEnglish (US)
Pages (from-to)533-538
Number of pages6
JournalClinical Toxicology
Volume48
Issue number6
DOIs
StatePublished - Jul 2010

Keywords

  • Embolic gas
  • Hydrogen peroxide
  • Hyperbaric oxygen
  • Portal venous gas

ASJC Scopus subject areas

  • Toxicology

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