Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2017; 5(10): 378-380
Published online Oct 16, 2017. doi: 10.12998/wjcc.v5.i10.378
Hydrogen peroxide ingestion with injury to upper gastrointestinal tract
Jonathan V Martin, Choichi Sugawa
Jonathan V Martin, Choichi Sugawa, Michael and Marian Ilitch Department of Surgery, 6-C University Health Center, Detroit, MI 48201, United States
Author contributions: Martin JV and Sugawa C contributed to the initial drafting and editing of manuscript; Sugawa C obtained clinical data.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards at Wayne State University.
Informed consent statement: Formal consent not required for case reports that have all 18 protected health information de-identified.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Choichi Sugawa, MD, Professor, Michael and Marian Ilitch Department of Surgery, 6-C University Health Center, 4201 Saint Antoine St., Detroit, MI 48201, United States.
Telephone: +1-313-5775001 Fax: +1-313-5775310
Received: March 28, 2017
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.

Keywords: Hydrogen peroxide, Caustic injury, Hyperbaric oxygen therapy, Ingestion of hydrogen peroxide, Arterial gas emboli

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.