Pii: S1010-7940(02)00045-3

Background: The objective of this study is to assess the incidence and long-term results of a rarely discussed medical problem – aspiration pneumonia resulting from the intentional ingestion of acid. Materials and methods: The medical records of 370 patients treated at one tertiary care institution for corrosive acid injury during a 12-year period were reviewed retrospectively. The study subjects included any patients who were found to have acid ingestion related aspiration pneumonia confirmed by chest film within 24 h of injury. All available data of these patients with or without aspiration pneumonia were analyzed. Results: Of the 370 patients with corrosive acid injury, 15 (4.2%) had acid-aspiration pneumonia which was related to their intentional ingestion of a strong acid, hydrochloric acid (pH , 1). The data for 14 patients with aspiration pneumonia and 268 without aspiration pneumonia was complete and available for analysis. Patients with aspiration pneumonia were found to be significantly older (52:2 ^ 6:2 to 41:7 ^ 0:9 years old, P 1⁄4 0:017), had a higher incidence of nasogastric tube irrigation (35.7–6.0%, P 1⁄4 0:000), had more conscious disturbance (50.0–17.5%, P 1⁄4 0:016), and required more endotrachal tube intubation (50.0–3.0%, P 1⁄4 0:000). Aspiration pneumonia was found to significantly increase the mortality rate in acid injured patients who required emergency abdominal surgery (87.5–32.0%, P 1⁄4 0:000) and in those who did not (28.5–5.1%, P 1⁄4 0:05). Two of the six survivors of aspiration pneumonia later developed laryngeal sequelae. Conclusions: Aspiration pneumonia rarely occurs as a consequence of acid ingestion. When it does occur, it greatly increases the mortality rate of those involved. For those who survive, physicians can expect some laryngotracheal sequel in long-term follow-up. q 2002 Elsevier Science B.V. All rights reserved.