Hydrogen Peroxide H2O2 Poisoning: Air in the Liver

Hydrogen peroxide (H2O2) is an oxidizing agent with lots of domestic and industrial applications. Its accidental ingestion can cause toxicity by three different mechanisms: corrosive injury, oxygen gas formation, and lipid peroxidation. We report a case of a 77-year-old male, who presented with irritating cough and hoarseness following accidental ingestion of a 5-10% solution of H2O2. Computed tomography (CT) scans of the neck, chest, and abdomen showed extensive intrahepatic portal venous gas. An esophagogastroduodenoscopy (EGD) revealed a moderate gastritis. The patient was treated with intravenous fluids and proton-pump inhibitor (PPI). A CT scan control at 12 h revealed complete disappearance of gas in the liver. One week after the admission, he started solid diet, and he was able to eat without difficulty or pain, and he was discharged home.