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Eur J Cardiothorac Surg 2002;21:638-643
© 2002 Elsevier Science NL

Outcome of acid ingestion related aspiration pneumonia

^a Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
^b Department of Surgery, Thoracic division, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138 Sheng-Li Road, Tainan, Taiwan, ROC

Received 27 August 2001; received in revised form 28 December 2001; accepted 15 January 2002.

* Corresponding author. Tel.: +886-6-2353535-5187; fax: +886-6-276-6676
e-mail: tsengyl{at}mail.ncku.edu.tw

Background: The objective of this study is to assess the incidence and long-term results of a rarely discussed medical problem – aspiration pneumonia resulting from the intentional ingestion of acid. Materials and methods: The medical records of 370 patients treated at one tertiary care institution for corrosive acid injury during a 12-year period were reviewed retrospectively. The study subjects included any patients who were found to have acid ingestion related aspiration pneumonia confirmed by chest film within 24 h of injury. All available data of these patients with or without aspiration pneumonia were analyzed. Results: Of the 370 patients with corrosive acid injury, 15 (4.2%) had acid-aspiration pneumonia which was related to their intentional ingestion of a strong acid, hydrochloric acid (pH<1). The data for 14 patients with aspiration pneumonia and 268 without aspiration pneumonia was complete and available for analysis. Patients with aspiration pneumonia were found to be significantly older (52.2±6.2 to 41.7±0.9 years old, P=0.017), had a higher incidence of nasogastric tube irrigation (35.7–6.0%, P=0.000), had more conscious disturbance (50.0–17.5%, P=0.016), and required more endotrachal tube intubation (50.0–3.0%, P=0.000). Aspiration pneumonia was found to significantly increase the mortality rate in acid injured patients who required emergency abdominal surgery (87.5–32.0%, P=0.000) and in those who did not (28.5–5.1%, P=0.05). Two of the six survivors of aspiration pneumonia later developed laryngeal sequelae. Conclusions: Aspiration pneumonia rarely occurs as a consequence of acid ingestion. When it does occur, it greatly increases the mortality rate of those involved. For those who survive, physicians can expect some laryngotracheal sequel in long-term follow-up.

Key Words: Aspiration pneumonia • Acid-corrosive injury

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