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Toxicological information

Direct observations: clinical cases, poisoning incidents and other

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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-referenceopen allclose all
Reason / purpose for cross-reference:
reference to same study
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

Constituent 1
Chemical structure
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.

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