Aluminum Phosphide Poisoning and Blast in Gastric Tube a Rare Phenomenon- A Case Report

Abstract

Suicide by poisoning is the second most common cause of death by suicide (27.9%) as per The National Crime Records Bureau (NCRB) India in 2015.Aluminum phosphide (ALP) is the leading agricultural poison used to commit suicide as where its availability is not properly regulated. Aluminum phosphide (ALP) is a highly toxic solid fumigant pesticide, rodenticide and insecticide. It is commonly used as outdoor and indoor pesticide in developing countries like India, Pakistan, Srilanka and Iran because it is a cheap, effective, free from toxic residue and do not alter the viability of seeds. Aluminium Phosphide (ALP) is a highly toxic fumigant which is used commonly as an indoor pesticide in agriculture based industry for storage of grains. ALP on ingestion reacts with a gastric water and release phosphine gas, which is highly flammable, and very toxic in nature. Over the last few decades ALP has emerged as an agent of choice being used as suicidal poisoning in a country where it is readily available. The high mortality rate is due to severe mitochondrial dysfunction leading to disruption of cellular respiration, causing tissue hypoxia and organ dysfunction. Despite long research no specific antidote could be developed and the treatment remained supportive. Spontaneous ignition of phosphine (PH3) is a rare but very peculiar phenomenon reported in the case of aluminium phosphide poisoning. Here we share our experience in a case of phosphine (PH3) poisoning, which presented with spontaneous ignition and blast during treatment which caught the attention of local and national media in India,