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May 13, 1974

An Unusual Complication of Lye Ingestion

JAMA. 1974;228(7):871. doi:10.1001/jama.1974.03230320041028

THE INGESTION of lye, either as a suicidal measure or accidentally, leads to multiple problems.

Lye (sodium hydroxide) is highly destructive and may lead to perforation of the esophagus by liquefaction necrosis.1 Hypovolemic shock and bacterial invasion are other immediate dangers of lye ingestion. Additional well-known complications are stricture formation, pulmonary insufficiency as the result of repeated aspirations, and perforation of the esophagus or stomach as a result of endoscopic examination. Necrosis of the tissues may extend through the entire esophageal wall, producing periesophagitis, pleurisy, pericarditis, mediastinitis, and bronchoesophageal fistula.2 Chemical gastritis, peritonitis, pulmonary edema, and laryngeal obstructions are other possible complications. Cardona and Daly3 reported duodenal ulcerations and strictures as a result of lye ingestion.

The effects of alkali ingestion are seen primarily in the upper gastrointestinal tract.4 In our patient, lye ingestion led to perforations of the small intestine and colon. To our knowledge,