J Korean Soc Emerg Med.  1999 Mar;10(1):128-132.

A Case of Dichloromethane Intoxication Following Ingestion

• Yoo JH
• Kim CW
• Jung KY

Abstract

The Dichloromethane(methylene chloride) is a highly volatile liquid used as a solvent, extraction medium, and paint remover. The most significant route of intoxication to dichloromethane is generally inhalation at work site or home, but ingestion is rare. The main toxicological harvard insults from in vivo conversion of dichloromethane to carbon monoxide. We present a case of dichloromethane intoxication following ingestion. A 71 years old male patient ingested 60-70cc of dichloromethane was brought to emergency department after stomach washout via nasogastric tube at other hospital. On arrival at emergency department(approximately 19 hours after ingestion), he was stuporous with a blood pressure 140/90mmHg, heart rate of 92 beats/min, dyspneic, respiratory rate of 24/min and body temperature 36.8 degrees C. His Pupils were isocoric, miotic, and sluggishly reactive. There were mucosal bums and significant secretion in oral cavity. On auscultation, breathing sound was coarse without role on both lung field. The COHb levels were 6.3%at 32 hours after ingestion and normalized to 0.6%at 44 hours after ingestion. Patient was transfered to intensive care unit and supportive care was started with 100% oxygen. On ingestion 4th day, chest X-ray showed pulmonary edema and acute respiratory distress syndrome developed. Patient regained the consciousness on the 11th day. On the 30th day, respiratory function improved and the ventilator was removed. Alveolitis and mild pulmonary fibrosis developed and mild dyspnea was continued. On the 36th day, gastroscopic examinations showed ulceration of esophagus and stomach. On the 76th day, patient was discharged after pulmonary rehabilitation.

MeSH Terms

Aged
Auscultation
Blood Pressure
Body Temperature
Carbon Monoxide
Consciousness
Dyspnea
Eating*
Emergencies
Emergency Service, Hospital
Esophagus
Heart Rate
Humans
Inhalation
Intensive Care Units
Lung
Male
Methylene Chloride*
Mouth
Oxygen
Paint
Pulmonary Edema
Pulmonary Fibrosis
Pupil
Rehabilitation
Respiratory Distress Syndrome, Adult
Respiratory Rate
Respiratory Sounds
Stomach
Stupor
Thorax
Ulcer
Ventilators, Mechanical
Workplace
Carbon Monoxide
Methylene Chloride
Oxygen