EVALUATION OF GASTROINTESTINAL COMPLICATIONS OF SULFUR MUSTARD POISONING IN IRANIAN COMBATANTS

A total of360 Iranian combatants who were exposed to mustard gas by the Iraqi forces in the war fronts were studied. Acute effects and gastrointestinal (GI) complications of sulfur mustard (S M) intoxication were studied separately in Iranian combatants admitted to Imam Reza Hospital from January 1984, to May 198X, In order to record the clinical and paraclinical findings, a special examination sheet and a questionnaire were designed. Routine laboratory tests such as CBC and ESR were performed for all patients and further investigation such as upper G [ endoscopy were done as clinically indicated. Common GI symptoms were: nausea (47%), vomiting (42%), anorexia (40%), abdominal pain (35%), diarrhea (15%), melena (7%), and hematemesis (5%). Based on physical examination and endoscopy, acute esophagitis and gastritis were diagnosed. In the chronic phase 298 patients were observed two months to six years after exposure. Common GI symptoms were recorded as nausea (45%), anorexia (42%), abdominal pain (38%), hematochezia (12%), and hematemesis (5%). Based on upper GI series and endoscopy, gastritis (12%), duodenitis (8%), and duodenal ulcer (I %) were diagnosed. Other complications such as hepatomegaly and gastric carcinoma that were reported in the literature from the First World War experience, have not yet been observed in our patients. Only in one patient who was admitted for abdominal discomfort five years after SM poisoning, gastritis with intestinal metaplasia was observed on endoscopy and biopsy from the stomach.