China Medical University Hospital, Department of Emergency Medicine, No.2 Yuh Der Road, Taichung, 40402 Taiwan.
Clin Toxicol (Phila). 2011 Nov;49(9):870-1. doi: 10.3109/15563650.2011.607460. Epub 2011 Oct 5.
Corrosive injury of the esophagus and stomach is never been reported after intoxication of hand warmers. Herein we reported a case that had grade IIA corrosive injury found by endoscopic examination.
An 84 year-old woman with a history of dementia ingested the contents of hand warmers. She had radiopaque patches in the stomach and duodenum. Upper endooscopic examination revealed corrosive injury of the esophagus and stomach. She recovered with the use of deferoxamine and proton pump inhibitor (PPI).
The hand warmer contains activated charcoal, salt, and vermiculite, and 50% of iron powder. In previous literature, ingestions of one hand warmer packet or less are considered less toxic. But in our case, corrosive injury of the esophagus and stomach is obvious.
It appears that significant toxicity will occur after ingestion of one hand warmer packet. Appropriate gastrointestinal decontamination and aggressive management are needed for all patients who are hand warmers intoxicated.
手暖器中毒后从未报道过食管和胃的腐蚀性损伤。在此，我们报告了一例内镜检查发现 IIA 级腐蚀性损伤的病例。
一名 84 岁女性，有痴呆症病史，摄入了手暖器的内容物。她的胃和十二指肠有不透射线的斑块。上内窥镜检查显示食管和胃有腐蚀性损伤。她使用去铁胺和质子泵抑制剂 (PPI) 康复。
手暖器含有活性炭、盐和蛭石，以及 50%的铁粉。在以前的文献中，摄入一个手暖器包或更少被认为毒性较小。但在我们的病例中，食管和胃的腐蚀性损伤很明显。
摄入一个手暖器包后似乎会发生明显的毒性。所有手暖器中毒的患者都需要进行适当的胃肠道去污和积极的治疗。
