Clinitest Tablet Ingestion with Thermal Burns of the Esophagus and/or Stomach

 

Chemical contents:

(1) copper sulfate

(2) sodium carbonate

(3) sodium hydroxide

(4) citric acid

 

Situations of exposure:

(1) accidental by small children (confuse with candy)

(2) accidental by adults (confuse with a medication)

(3) suicidal attempt

 

Thermal burns may occur in the:

(1) esophagus (upper two thirds in adults, lower two thirds in children)

(2) gastric fundus or pylorus

 

The risk is affected by:

(1) the number of pills ingested

(2) the presence of something to slow the pill progression (stricture, lying down, etc.)

(3) the amount and type of liquid ingested (no liquid associated with higher risk)

 

Management should be prompt ingestion of fluid to dilute the chemicals and reduce thermal injury. Orange juice is a good diluent, since it both dilutes the pill and lowers the pH.