Gastric perforation after polyurethane foam ingestion

Abstract

Introduction

Acute intoxication rarely produces conditions that require urgent surgical care.

Case summary

A 45-year-old man presented to the emergency department with severe abdominal pain after the deliberate ingestion of 200 cm³ of polyurethane mixed with methylene diphenyl diisocyanate and urethane primers. On an initial laparoscopic examination, foreign material was observed in the peritoneal space with haemoperitoneum. Emergency exploration was then undertaken for suspected gastric perforation. Full-thickness damage was identified on the stomach wall during the operation. The material in the gastrointestinal tract and peritoneal space was gently removed. Moulded casts of the entire stomach and distal oesophagus were extracted successfully. The patient was discharged 14 days after surgery.

Images

Computed tomography revealed foreign material occupying the entire gastric chamber, as well as diffuse gastric perforation.

Conclusions

Life-threatening gastric perforation can occur after polyurethane foam ingestion. Clinical/medical toxicologists and emergency physicians need to be aware of the highly expandable nature of this agent.

Keywords:

• Polyurethane foam
• gastric perforation
• blast injury
• suicide attempt
• acute care surgery

Author contributions

Conceptualization: Nho WY. Data curation: Yu B. Writing – original draft: Park KB. Writing – review and editing: Nho WY and Park J.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available on request from the corresponding author [WYN].

Additional information

Funding

This study did not receive any financial support.