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White phosphorus poisoning by oral ingestion of firecrackers or little devils: Current experience in Ecuador

Abstract:

Background.White phosphorus (WP) is widely used illicitly in fireworks in South America. We report our experience in seven Ecuadorian hospitals. Methods.A cross-sectional study of patients presented during 2009. Inclusion criteria included: reported oral ingestion of firecrackers (little devils) in any age. Data were gathered using inpatient records and a written survey of the victims. Results.The mean age of the patients was 21.6±7.1 years (women 63.5%); 64.7% of cases occurred in November, December and January. In 46% of cases, the number of units ingested was between 1 and 5 (∼0.3 to 1.5 g WP), maximum 40 (∼12g). Forty-seven cases attended within 12 hours (55.3%); 5.9% died and 2.4% were readmitted. The remainder were eventually discharged well. Clinical features included: abdominal pain, cramps, diarrhoea, jaundice, nausea and vomiting, abnormal liver enzymes, and coagulation times and hypoglycaemia. Conclusions.The typical case was an adolescent woman between 16 and 19 years with self-harm around Christmas. There was no specific treatment, but early attendance was associated with improved prognosis. Further studies are necessary to establish an adequate protocol of treatment. © 2011 Informa Healthcare USA, Inc.