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Critical airway induced by formalin injection: case report

Published online by Cambridge University Press:  13 December 2013

C-F Yeh
Affiliation:
Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan Department of Otolaryngology, National Yang-Ming University, Taipei, Taiwan
T-L Lee*
Affiliation:
Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan Department of Otolaryngology, National Yang-Ming University, Taipei, Taiwan
*
Address for correspondence: Dr T-L Lee, Department of Otolaryngology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, Republic of China Fax: +886 2 28757338 E-mail: ent2424@gmail.com

Abstract

Background:

Formalin is a saturated aqueous solution comprising 37–40 per cent formaldehyde. It is often used in histopathology laboratories as a tissue preservative. The ingestion or injection of formalin has an immediate, powerful and destructive impact on humans. This paper reports a case of formalin injection and reviews the relevant world literature.

Case report:

A 36-year-old male attempted suicide by injecting formalin into the right side of his neck, resulting in a critical airway situation. An endotracheal tube was inserted and a tracheostomy was then performed to secure his airway. After receiving medical treatment, including antibiotics and N-acetyl cysteine, the status of the patient's airway improved.

Conclusion:

When examining patients who have injected substances into their neck, the possibility of deep neck inflammation with airway compromise should be considered. Immediate management, which should include establishment of a definitive airway and prophylactic infection control, is crucial.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2013 

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References

1IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Formaldehyde, 2-butoxyethanol and 1-tert-butoxypropan-2-ol. IARC Monogr Eval Carcinog Risks Hum 2006;88:1478Google Scholar
2Pandey, CK, Agarwal, A, Baronia, A, Singh, N. Toxicity of ingested formalin and its management. Hum Exp Toxicol 2000;19:360–6Google Scholar
3Pongsavee, M. In vitro study of lymphocyte antiproliferation and cytogenetic effect by occupational formaldehyde exposure. Toxicol Ind Health 2011;27:719–23Google Scholar
4Yanagawa, Y, Kaneko, N, Hatanaka, K, Sakamoto, T, Okada, Y, Yoshimitu, S. A case of attempted suicide from the ingestion of formalin. Clin Toxicol (Phila) 2007;45:72–6Google Scholar
5Hilbert, G, Gruson, D, Bedry, R, Cardinaud, JP. Circulatory shock in the course of fatal poisoning by ingestion of formalin. Intensive Care Med 1997;23:708Google Scholar
6Koppel, C, Baudisch, H, Schneider, V, Ibe, K. Suicidal ingestion of formalin with fatal complications. Intensive Care Med 1990;16:212–14Google Scholar
7Casanova, M, Heck, Hd'A. Further studies of the metabolic incorporation and covalent binding of inhaled [3H]- and [14C]formaldehyde in Fischer-344 rats: effect of glutathione depletion. Toxicol Appl Pharmacol 1987;89:105–21Google Scholar
8Arakeri, G, Brennan, PA. Inadvertent injection of formalin mistaken for local anesthetic agent: report of a case. Oral Surg Oral Med Oral Pathol Oral Radiol 2012;113:581–2Google Scholar
9Gupta, DS, Srivastava, S, Tandon, PN, Jurel, S, Sharma, S, Singh, S Jr.Formalin-induced iatrogenic cellulitis: a rare case of dental negligence. J Oral Maxillofac Surg 2011;69:e525–7CrossRefGoogle ScholarPubMed
10Putterman, AM. Accidental formaldehyde injection in cosmetic blepharoplasty: case report. Arch Ophthalmol 1990;108:1920Google Scholar
11Lisman, RD, Hyde, K, Smith, B. Complications of blepharoplasty. Clin Plast Surg 1988;15:309–35Google Scholar
12Smith, BC, Nesi, FA. Upper lid loss due to formalin injection: surgical reconstruction. Ophthalmology 1979;86:1951–5Google Scholar