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Esophageal Injuries Due to Aluminum Phosphide Tablet Poisoning in India

Department of Thoracic & Cardiovascular Surgery
¹ Department of Anesthesia KGM University Lucknow, India

For reprint information contact: Shekhar Tandon, MCh, Tel: 91 522 239 1919, Fax: 91 522 225 5394, Email: darbari1{at}indiatimes.com, Thoracic & Cardiovascular Surgery Department, KGM University, Lucknow – 226 003, India.

Aluminum phosphide is a lethal systemic poison with 80%–90% mortality. Survivors have taken either a very small amount or the tablet had been exposed to air, rendering it less toxic, but often causing severe esophageal injuries. The presentation and treatment of 11 cases of esophageal injury due to aluminum phosphide are described. Ten patients had esophageal stricture, and 1 had tracheoesophageal fistula with stricture. Endoscopic bougie dilatation was sufficient in 7 patients, and surgical intervention was required in 4 who underwent definitive repair via gastric tube or feeding jejunostomy with a 2^nd stage repair planned in 2. There was no mortality but significant morbidity. Mortality and morbidity might be prevented by withdrawing this pesticide from the market, making its sale difficult, or modifying the packaging.