Corrosives poison

1. CORROSIVE POISON

2. CORROSIVE POISON
• Chemicals (that can be found in many
household products) that are considered highly
reactive and thus are very dangerous upon
ingestion or skin contact
• Action: Fix,destroy and erode the surface
which comes in contact with the poison

3. EXPULSION
• Dilution is made with water by 5 ml for1 kg inorder to
reduce concentration
• Gastric lavage is absolutely contraindicated in case of
corrosive poisoning because it leads to deeper
perforation
CIRCUMSTANCES OF POISONING:
• Mostly suicidal
• Sometimes accidental poisoning may occur
• Internally injected into vagina as abortifacient

4. • Strong mineral acid which comes in contact with surface of skin
produces exothermic reaction which leads to coagulation
necrosis
• Results in systemic acidosis, hemolysis, Decreased cardiac
output
• Primary damage will be superficial but later perforation happens
and stomach lining gets sloughed off
• Complication like Mediastinitis, sepsis, shock and death
happens.
MINERAL ACIDS:

5. • If corrosives gets injested, greatest damage to
stomach and pylorus but minimal damage in
oropharynx and oesophagus
• Corrosive mineral acid and alkali can be identified by
GIT contents
• No trace acid is found in stomach , if the victim
survives for more than 2 days as it gets penetrate
deeper

6. CHARACTERISTIC :
H2SO4 ; Oil of vitriol
Heavy , Odourless, colourless, non fuming , oily
liquid
COLOUR:
Dark or brown colour
ACTION:
When the surface contact with H2SO4
Initially – Superficial burns will be there
After 30 sec – Full thickness of skin
H2SO4 ( Sulphuric acid )

7. SIGNS AND SYMPTOMS:
Lips - Swollen; black or brown streaks from
mouth to chin
Teeth- chalky white colour
Eye - Strunken and pupil dilated
Voice- Hoarse and Husky
Mind - will be clear till death so no
psychological changes

8. • The mucous membrane of Mouth , Throat,
Oesophagus gets corroded
• Pharyngeal pain will be most common symptom.
• Nausea , Vomiting will be there
• Vomit will be brown or black , mucoid , strong acid
and it contains shaded part of stomach
• Intense thirst will be present but attempt to drink
water causes vomiting
• Circulatory collapse causes asphyxia leads to
immediate death

9. CAUSE OF DEATH:
1.Circulatory collapse
2.Spasm of glottis
3.Collapse of stomach due to perforation
4.Toxaemia
5.Delayed death – secondary infection, Renal failure
Fatal dose -10-15ml
Fatal period - 12-24 hours

10. COMPLICATION:
Acute:
• Upper airway Obstruction
• GI haemorrhage
• Oesophageal and gastric perforation
• Sepsis
• Tracheobronchial necrosis
Chronic:
• Oesophageal obstruction
• Pyloric stenosis
• Vocal cord paralysis with airway obstruction

11. TREATMENT:
1. Avoid gastric lavage or emetics
2. Should be diluted in-situ by giving a glass of water, milk, lime
water, 4 TSP of Al(OH)3 gel
3. Give demulcents like olive oil , egg whites, starch water
4. Prednisolone 60 mg / day in divided dose
5. Tracheostomy done in case of edema of glottis
6. Nothing should be given by mouth , nutritive substances only by
IV ( 1 week) only liquid and soft foods should be given
7. For skin burns , Paste of MgO
8. Morphine relieves pain
9. For eye burns water or Na(CO)3 solution
10. Symptomatic treatment

12. External:
• Depends on the quantity and strength of acid used
• Necrotic area initially greyish white and later brown or
black
• Corrosion of mucous membrane of lips , mouth,throat, hands.
Internal:
• URT - Inflammed , swollen, Interstial haemorrhage
• Oesophagus- Squamous epithelium damage, perforation
rare..
POSTMORTEM APPEARANCE

13. STOMACH
OSOPHAGUS

14. Stomach :
• Soft , spongy , black mass, greater part gets erroded,
• Mucosa + blood reacts and produces acid haematin and
leads to acute erosion and wall of the stomach will be black
or brown
• In Stomach contents calcium oxalate crystal will be present
• Perforation occurs with the escape of gastric contents into
peritoneal cavity leads to Organ corrosion, Peritonitis
• Perforation of stomach happens
Larynx and Trachea gets corroded and inflammed
Liver and Kidney will have secondary swelling;

15. Time course of injury :
• Acute inflammatory stage – 4-7 days
( Perforation and acidosis)
• Granulation -4-7 days
• Perforation – between 7- 21 days
• Cicatrisation stage – At 3 weeks and persist for years
Tests:
1.Strong acid chars Organic matter
2. Barium nitrate / Barium chloride solution produces
white precipitate of Ba(so)4

16. VITRIOLAGE
(VITRIOL THROWING)

17. DEFINITION:
It is throwing of any
corrosive (sulphuric acid)
on another individual with
malicious intent to
disfigure them.

18. SUBSTANCE
USED:
Most commonly used: Sulphuric
acid,
OTHER SUBSTANCES:
Nitric acid,carbolic acid,
caustic soda, caustic potash,
iodine, calotropics.

19. CHARACTERISTICS OF BURNS:
• Discoloration and staining of skin (brown
in sulphuric acid, yellow in nitric acid)
• Trickle marks
• Painless burns
• Repair is slow and scar tissue causes
contractures.

20. SULPHURIC ACID BURN NITRIC ACID BURN

21. TREATMENT:
• Wash the parts with water and soap,
• Apply thick paste of MgO,
• Cover raw surface with antibiotic ointment,
• For eye burns,.
anaesthetic drops are used and irrigated with
water for 15 mins. Repeat
irrigation using 0.9% saline,

22. MEDICO LEGAL ASPECT:
• Fluids are thrown with object of destroying vision or
causing facial disfigurement (Grevious hurt) SEC.
320 IPC
• Punishable under SEC.326- A IPC, (voluntarily
causing Grevious hurt) 10yr - life imprisonment and
fine,
• SEC 326 - B IPC, ( attempting to throw acid ) 5-7
yrs imprisonment and fine.