sulfuric acid poisoning
sulfuric acid poisoning
Symptoms
Early local effects of acid injury, e.g., necrosis of the skin or the upper gastrointestinal tract, result from direct contact of sulfuric acid with the epithelium. The patient may complain of intense pain, e.g., in the mouth or throat. If acid contacts the eye, it may cause pain and corneal injury, sometimes resulting in blindness. Several days to 2 weeks after massive acid ingestion, perforation of internal organs may occur. When the stomach is involved, the perforation may leak acid into the mediastinum or peritoneum, causing pain, dyspnea, hypotension, tachycardia, or shock.
Treatment
Exposed surfaces should be promptly washed in water to dilute the concentration of acid and minimize the depth of acid penetration. If the airway is compromised, the patient should be immediately intubated and ventilated, before undergoing dilutional therapy. Activated charcoal, which is helpful in many other exposures, is not useful. Neutralizing substances such as diluted alkalies are probably not helpful.
Most patients who ingest significant quantities of acid will undergo upper gastrointestinal endoscopy to evaluate the extent of the acid burn. Strictures, e.g., esophageal strictures, that develop as a result of scarring from acid burns are treated with dilation. People with ocular exposures need immediate ophthalmological consultation. Immediate surgery is warranted for patients with internal organ perforation.acids in