CASE REPORT

A 62-year-old female, who was depressed and whose medical history included an overdose, presented to the emergency department after ingesting ˜100 mL of household laundry bleach (hydrogen peroxide concentration: 3%–5%) in a suicide attempt. On clinical examination, she had no signs of peritoneal irritation or neurological abnormalities. Abdominal contrast-enhanced computed tomography (CT) performed at 3 h after ingestion showed hepatic portal vein gas (HPVG) (Fig. 1A). Contrast-enhanced CT was performed again the next morning (18 h after ingestion) and showed that the HPVG had disappeared (Fig. 1B). Upper gastrointestinal endoscopy showed mucosal injuries in the esophagus and stomach. Because the patient’s general condition improved after proton pump inhibitor treatment alone, she was transferred to a psychiatric hospital on day 5 of hospitalization.

Contrast-enhanced CT of the abdomen (3 h after ingestion) showed hepatic portal vein gas (A), which disappeared after 15 h (B).

DISCUSSION

There have been several reports of HPVG caused by the accidental ingestion of highly concentrated hydrogen peroxide (35%), which occasionally involved gas emboli, especially cerebral infarctions.1-3 In this case, HPVG was detected after the ingestion of household laundry bleach containing diluted hydrogen peroxide (concentration: 3%–5%). Because diluted hydrogen peroxide can cause gas emboli when ingested, HPVG that arises after the ingestion of hydrogen peroxide requires careful management, regardless of the hydrogen peroxide concentration.

Acknowledgements

We would like to thank Medical English Service for their help with the English language editing.

Funding Information

No funding information provided.

Disclosure

Approval of the research protocol: N/A.

Informed consent: Obtained from the patient.

Registry and the registration no. of the study/trial: N/A.

Animal studies: N/A.

Conflicts of interest: None declared.

References

1Watt BE, Proudfoot AT, Vale JA. Hydrogen peroxide poisoning. Toxicol. Rev. 2004; 23: 51– 7. 2Youssef EW, Chukwueke VS, Elsamaloty L, Moawad S, Elsamaloty H. Accidental concentrated hydrogen peroxide ingestion associated with portal venous gas. J. Radiol. Case Rep. 2018; 12: 12– 6. 3Furtado S, Jodoin S, Hu W, Sevick R. Accidental hydrogen peroxide ingestion. Can. J. Neurol. Sci. 2002; 29: 276– 7.