Fink Katrin, Kuehnemund Alexander, Schwab Tilmann, Geibel-Zehender Annette, Bley Thorsten, Bode Christoph, Busch Hans-Joerg
University Hospital, Freiburg im Breisgau, Germany.
J Emerg Med. 2010 Nov;39(5):618-22. doi: 10.1016/j.jemermed.2008.08.013. Epub 2009 Feb 13.
There is much experience with intoxication by aspiration of volatile hydrocarbon products, whereas intravenous injection of these distillates is rare. There are only few reports that describe a wide variety of associated pathological changes, predominantly in the pulmonary system.
We report the case of an intravenous self-injection of gasoline by a young man in a suicide attempt.
Immediately after injecting gasoline, the 22-year-old man developed bradycardia, hypotension, and increasing dyspnea. Computed tomography scan of the chest showed signs consistent with diffuse alveolar-toxic damage to the lung. These symptoms and radiological findings are similar to those commonly observed after inhalation of this type of substance. This may have been due to diffusion of gasoline into the alveoli, where its presence leads to this characteristic damage. In this patient, gasoline entered the intramuscular tissue, and the patient developed a soft-tissue phlegmon at the forearm. At operation, gas emanation and superficial necrosis were noted. Nevertheless, the patient's outcome was good, with full recovery within 3 weeks.
The major changes in this patient after intravenous injection of gasoline were in the pulmonary system, including hypoxemia and radiological findings that could be related to an exhalation of the volatile substance. In addition, gas in the musculature of the injection area caused a soft-tissue phlegmon.
吸入挥发性碳氢化合物产品中毒已有很多经验，而静脉注射这些馏出物则很少见。仅有少数报告描述了各种各样的相关病理变化，主要发生在肺部系统。
我们报告一名年轻男子自杀未遂静脉注射汽油的病例。
在注射汽油后，这名22岁男子立即出现心动过缓、低血压和进行性呼吸困难。胸部计算机断层扫描显示的征象与肺部弥漫性肺泡毒性损伤一致。这些症状和影像学表现与吸入此类物质后常见的表现相似。这可能是由于汽油扩散到肺泡中，其存在导致了这种特征性损伤。在该患者中，汽油进入了肌肉组织，患者前臂出现了软组织蜂窝织炎。手术时，发现有气体逸出和表面坏死。尽管如此，患者预后良好，3周内完全康复。
该患者静脉注射汽油后的主要变化发生在肺部系统，包括低氧血症和可能与挥发性物质呼出有关的影像学表现。此外，注射部位肌肉组织中的气体导致了软组织蜂窝织炎。
