RESUMO
Hydrogen peroxide is a clear and odorless liquid at room temperature that can easily be mistaken for water. Its ingestion results in varied clinical and radiological squeals depending on the volume and concentration of the liquid. We present a case of a 22-year-old lady who accidentally ingested 30 to 40 mL of 3% hydrogen peroxide and presented with hematemesis and abdominal pain. On further radiological evaluation, she was found to have portal venous gas and pneumatosis of the bowel wall. She was conservatively managed with 100% oxygen and nil per os for 2 days following which the portal venous gas resolved. Hydrogen peroxide ingestion causes a massive release of oxygen and when its volume exceeds its solubility in blood, gas embolism occurs that is responsible for portal venous gas and pneumatosis. Close monitoring with conservative management will suffice in mild cases without the need for any therapeutic intervention.
RESUMO
Hydrogen peroxide ingestion can cause gastric irritation and gas embolism; however, most reported cases are from the highly concentrated (≥35%) solution used in the industry and data on household-used 3% solution ingestion is scarce. We report a case of a portal vein gas embolism after ingestion of 3% hydrogen peroxide. The patient was managed conservatively with antacids and improved in 48 hours. Endoscopy and hyperbaric treatment were considered but not pursued. This is the fifth reported case of gas embolism after 3% hydrogen peroxide ingestion and stands in line with other reports where the patients improved with conservative management.