Sodium chloride

Direct observations: clinical cases, poisoning incidents and other

Administrative data

Endpoint:

direct observations: clinical cases, poisoning incidents and other

Type of information:

other: case report

Adequacy of study:

supporting study

Study period:

2009

Reliability:

2 (reliable with restrictions)

Rationale for reliability incl. deficiencies:

other: It is a case study report of Acute gastric ulcer. There is no specific guideline followed mentioned in the report.

Cross-reference

Cross-reference 1

Reason / purpose for cross-reference:

reference to same study

Cross-reference 2

Reason / purpose for cross-reference:

reference to other study

Data source

Reference

Reference Type:

other: Case report

Title:

Unnamed

Year:

2009

Materials and methods

Study type:

clinical case study

Test guideline

Qualifier:

no guideline available

Principles of method if other than guideline:

no data

GLP compliance:

not specified

Test material

Test material information

Constituent 1

Reference substance name:

Sodium chloride

EC Number:

231-598-3

EC Name:

Sodium chloride

Cas Number:

7647-14-5

Molecular formula:

ClNa

IUPAC Name:

sodium chloride

Details on test material:

- Name of test material (as cited in study report): Sodium Chloride

Method

Type of population:

general

Subjects:

- Number of subjects exposed:
- Sex:Male
- Age:20 year old

Ethical approval:

not specified

Route of exposure:

oral

Reason of exposure:

unintentional, non-occupational

Exposure assessment:

measured

Details on exposure:

A 20-year old Soldier was admitted to the emergency department, complaining of acute epigastric pain, vomitting and afebrile watery diarrhea, which appeared 48 hours after ingestion of a small ladle of coarse salt mixed with a small amount of sparkling wine.

Examinations:

Clinical examination
Blood count
Electrocardiography
Chest x-radiography
Abdominal ultrasound
Endoscopy of the upper digestive tract

Medical treatment:

Intravenous proton pump inhibitors (PPIs)-40mg/d and Sucralfate-4g/d

Results and discussion

Clinical signs:

Acute epigastric pain, vomiting and afebrile watery diarrhea.

Results of examinations:

Results of clinical examination, blood count, electrocardiography, chest x-radiography and abdominal ultrasound were normal. On day 3 after ingestion, endoscopy of the upper digestive tract showed intense congestive antral gastritis and a deep antral ulcer, surrounded by smaller ulcers around its entire circumference with no other abnormalities. The duodenal bulb and descending duodenum were macroscopically normal. Biopsies taken at the edge of the largest ulcer showed edema and serosal congestion with blood extravasation and central fibrinoid necrosis. No malignancy, no chronic gastritis, and no H.pylori infection observed. Epigastric pain disappeared after 7 days of treatment by intravenous protop pump inhibitors (PPIs) (40mg/d) and sucralfate (4g/d) begun just before endoscopy in the emergency unit. Endoscopic examination on day 7 still showed the large deep antral ulcer, but less marked congestive antritis. Both had healed by day 70 of PPI treatment.

Effectivity of medical treatment:

Endoscopic examination on day 7 still showed the large deep antral ulcer, but less marked congestive antritis. Both had healed by day 70 of PPI treatment.

Outcome of incidence:

Chronic ingestion of salt induces chronic gastritis, which can promote the development of gastric cancer in men. The digestive consequences of acute salt ingestion in humans are not well knwon. The case study reports the gastric lesions in young man, induced by accidental ingestion of coarse salt.

Any other information on results incl. tables

None

Applicant's summary and conclusion

Conclusions:

The first reported human case of acute gastric toxicity induced by ingestion of a coarse salt solution (nearly 16 grams) of smaller volume (0.23g/kg versus 0.5 to 1 g/kg) but higher concentration than in animal experiments. This concentration explains the gastric lesions. The potential severe gastric toxicity of coarse salt, a common ingredient.

Executive summary:

A 20 -year-old soldier was admitted to the emergency department, complaining of acute epigastric pain, vomiting, and afebrile watery diarrhea, which appeared 48hours after ingestion of a small ladle of coarse salt mixed with a small amount of sparkling wine.

Results of the clinical examination, blood count, electrocardiography, chest X-radiography, and abdominal ultrasound were normal. On day 3 after ingestion, endoscopy of the upper digestive tract showed intense congestive antral gastritis and a deep antral ulcer, surrounded by smaller ulcers around its entire circumference, with no other abnormalities. The duodenal bulb and descending duodenum were macroscopically normal. Biopsies taken at the edge of the largest ulcer showed edema and serosal congestion with blood extra vasation and central fibrinoid necrosis. No malignancy, no chronic gastritis, and no H.Pylori infection was observed. Epigastric pain disappeared after 7 days of treatment by intravenous protop pump inhibitors (PPIs) (40 mg/d) and sucralfate (4g/d) begun just before endoscopy in the emergency unit. Endoscopic Examination on day 7 still showed the large deep antral ulcer, but less marked congestive antritis. Both had healed by day 70 of PPI treatment.

The first reported human case of acute gastric toxicity induced by ingestion of a coarse salt solution (nearly 16 grams) of smaller volume (0.23g/kg versus 0.5 to 1 g/kg) but higher concentration than in animal experiments. This concentration explains the gastric lesions. The potential severe gastric toxicity of coarse salt, a common ingredient.