Published online Oct 16, 2017. doi: 10.12998/wjcc.v5.i10.378
Peer-review started: March 31, 2017
First decision: June 16, 2017
Revised: July 6, 2017
Accepted: August 2, 2017
Article in press: August 3, 2017
Published online: October 16, 2017
Hydrogen peroxide is a common over-the-counter solution that has developed a growing body of literature regarding toxic ingestion. Intentional ingestion of high concentration hydrogen peroxide for health purposes has gained popularity in certain patient populations; purported benefits are due to the increased oxygen released into the blood stream. We present for evaluation one such case with associated imaging that presented to our urban medical center. A brief review of the literature was also performed noting current recommendations regarding both outcomes and indications for endoscopy as well as hyperbaric oxygen therapy following ingestion of hydrogen peroxide. Our patient was a 51-year-old white female who presented with foamy hematemesis after ingesting 10 drops of 35% hydrogen peroxide as part of a home remedy to cleanse her colon and improve blood oxygenation. In addition to hematemesis, she also reported diffuse abdominal pain with sore throat and hoarse voice. Her imaging demonstrated portal venous gas and gastric edema. She was admitted for hyperbaric oxygen therapy and underwent upper endoscopy demonstrating diffuse esophagitis and gastritis with white exudate and multiple petechiae. She was later discharged home in stable condition and was lost to follow-up.
Core tip: In patients presenting with unresolving epigastric and hematemesis following ingestion of hydrogen peroxide, evaluation with endoscopy is indicated. Computed tomography and/or magnetic resonance imaging are also indicated to evaluate for formation of arterial gas emboli. Therapy is primarily supportive, ± hyperbaric oxygen therapy depending on presence of neurological symptoms, presence of gas emboli, and availability of resources.