[Acute oral acetic acid poisoning--case report].

We report on a female patient who attempted suicide by drinking 400 ml of 25% acetic acid. This amount is normally considered to be a lethal dose. Treatment was initiated about 2 hours after ingestion. Pain and shock were treated at first followed by the symptoms of haemolysis and renal failure. In severe corrosive injuries of the upper respiratory tract, intubation and ventilation are mandatory. After acid absorption, plasma separation is the quickest and most effective way of detoxication and removal of the products of haemolysis. In cases of severe haemolysis, exchange transfusion is necessary. In addition, careful management of the acid-base status is recommended. Disseminated intravascular coagulation or anaemia may develop. In this case, we used low dose heparin, erythrocyte transfusion and AT III substitution. In secondary renal failure, haemodialysis is recommended. When the acute intoxication has been treated, attention must be paid to fluid management and calorie intake. Care must be taken to exclude injury or stricture of the oesophagus or stomach. This case underlines the importance of immediate treatment of the haemolysis and detoxification with plasma separation with the immediate substitution of blood and clotting factors. In spite of an initial deterioration, the initiation of therapy led to a rapid improvement in circulation and renal function.