Boonekamp Caroline, Voruz François, Fehlmann Christophe
Department of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland.
Department of Otolaryngology and Head and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland.
BMJ Case Rep. 2018 Jun 21;2018:bcr-2018-224213. doi: 10.1136/bcr-2018-224213.
Sodium hydroxide is a corrosive, highly alkaline (PKa=14.8) household product. Ingestion of sodium hydroxide liquid is common, showing toxicity on the oesophagus and stomach. Nevertheless, cases of sodium hydroxide ingestions in pellet are rare and the management of them is unknown. We report the case of a 65-year-old man who accidentally swallowed a bleach tablet of 3.5 g. Six hours later, the patient developed an aphonia associated with dysponea stage IV, motivating a nasofibroscopy showing glottis and supraglottic necrosis and oedema for which the patient received intravenous steroids, was intubated and then underwent a tracheotomy. After 2 weeks under tracheotomy, local evolution was favourable allowing a removal of the cannula and a return back home.
氢氧化钠是一种腐蚀性很强的高碱性（pKa = 14.8）家用产品。摄入氢氧化钠液体的情况很常见，会对食管和胃产生毒性。然而，摄入氢氧化钠颗粒的病例很少见，其治疗方法也不明确。我们报告一例65岁男性意外吞服3.5克漂白剂片的病例。6小时后，患者出现失音并伴有IV级呼吸困难，促使进行鼻纤维镜检查，结果显示声门和声门上坏死及水肿，患者接受了静脉注射类固醇治疗，进行了插管，随后接受了气管切开术。气管切开术后2周，局部病情好转，得以拔除套管并回家。
