Acetic acid is a colorless liquid with a pungent vinegar-like order. Glacial acetic acid is 99% acetic acid. Acetic acid may lead to different effect on the damaged organ. Acetic acid ingestion is most common and results in pharyngeal, esophageal and GI burns, bleeding and volume depletion. Systemic effect include hemolysis, hepatic dysfunction, hypotension, renal failure and disseminated intravascular coagulation after ingestion of 90-100% acetic acid. Acute renal failure in acetic acid poisoning is rare and the mechanism of acute renal failure remains unclear. But tubular toxic effect of myoglobin or hemoglobin and direct action of acetic acid are suggested as the mechanism. Because of the acute renal failure may be fatal, the immediate treatment of hemolysis, substitution of blood and clotting factor and hemodialysis lead to improvement in general condition and renal function.
Acetic Acid* ; Acute Kidney Injury* ; Burns ; Disseminated Intravascular Coagulation ; Eating* ; Hemolysis ; Hemorrhage ; Hypotension ; Myoglobin ; Poisoning ; Renal Dialysis ; Renal Insufficiency

OBJECTIVE: We retrospectively evaluated the effectiveness of the esophageal balloon dilatation (EBD) in children with a corrosive esophageal stricture. MATERIALS AND METHODS: The study subjects included 14 patients (M:F = 8:6, age range: 17-85 months) who underwent an EBD due to a corrosive esophageal stricture. The causative agents for the condition were glacial acetic acid (n = 9) and lye (n = 5). RESULTS: A total of 52 EBD sessions were performed in 14 patients (range 1-8 sessions). During the mean 15-month follow-up period (range 1-79 months), 12 patients (86%) underwent additional EBD due to recurrent esophageal stricture. Dysphagia improved after each EBD session and oral feeding was possible between EBD sessions. Long-term success (defined as dysphagia relief for at least 12 months after the last EBD) was achieved in two patients (14%). Temporary success of EBD (defined as dysphagia relief for at least one month after the EBD session) was achieved in 17 out of 52 sessions (33%). A submucosal tear of the esophagus was observed in two (4%) sessions of EBD. CONCLUSION: Only a limited number of children with corrosive esophageal strictures were considered cured by EBD. However, the outcome of repeated EBD was sufficient to allow the children to eat per os prior to surgical management.
Acetic Acid/poisoning ; Balloon Dilatation/*methods ; Burns, Chemical/radiography/*therapy ; Caustics/poisoning ; Child ; Child, Preschool ; Deglutition Disorders/etiology ; Esophageal Stenosis/chemically induced/*radiography/*therapy ; Esophagus/radiography ; Female ; Humans ; Infant ; Lye/poisoning ; Male ; Retrospective Studies ; Treatment Outcome

PURPOSE: The incidence of infectious disease, which has been the cause of death in pediatric period, was decreased. But, the opportunistic exposure to toxic substance shows a tendency to increase. We performed this study in order to find out preventive measures and the latest inclination of acute poisoning in childhood. METHODS: From January 1985 to July 1996, 88 children with acute drug and chemical poisoning, who diagnosed at Presbyterian Medical Center, were analyzed retrospectively. RESULTS: 1) It occurred more frequently in male than female (1.7:1) and high incidence was noted in 0-4 year-old age group (75%). 2) Annual distribution of poisoning shows a tendency to increased. 3) There was no significant seasonal difference in frequency of poisoning. 4) The vast majority (85%) of poison exposure were accidental and therapeutic intent was present in 7.5% of cases and suicidal intent was 7.5% of cases. 5) We noticed an hourly predominance with most accidents occurring from 9 a.m. to 1 p.m. and from 5 p.m. to 9 p.m., 35% respectively. 6) Categories with the largest numbers of total exposure, in descending order by exposure frequently, include the following : drug (30.1%), insecticide (20.4), rodenticide (12.9%), glacial acetic acid (13.9%), herbicide (4.3%), Carbon monoxide (3.2%), others (13%). So, food and household material are leading cause of poisoning, except drug. Of drug, DDS was the most common and then psychotherapeutic drugs were the next. 7) The chief complaints on admission were nausea and vomiting (32%), mental change (26%) irritability (9%), peripheral cyanosis (8%), seizure (5%), and in case of 20%, the patient were found incidentally without symptoms. 8) There were complications which were pneumonia, pulmonary fibrosis, esophageal stricture and pneumothorax. And death occurred in 4 cases, due to insecticide (2 cases), herbicide and rodenticide, 1 case respectively. CONCLUSIONS: In previous report in Korea, causative substance of poisoning were drug, carbone monoxide, insecticide, rodenticide in descending order. In our study, drug was the most common cause of poisoning. But it' s proportion was decreased compared with previous report, and carbone monoxide intoxication was markedly decreased. But, we noticed that the proportion of household material, such as glacial acetic acid and other household chemical, was increased. So, we should be pay more attention to poisoning and try to prevent them.
Acetic Acid ; Carbon ; Carbon Monoxide ; Cause of Death ; Child ; Communicable Diseases ; Cyanosis ; Esophageal Stenosis ; Family Characteristics ; Female ; Humans ; Incidence ; Korea ; Male ; Nausea ; Pneumonia ; Pneumothorax ; Poisoning* ; Protestantism ; Pulmonary Fibrosis ; Retrospective Studies ; Seasons ; Seizures ; Statistics as Topic* ; Vomiting