Acute Pancreatitis- A Lesser-known Complication of Celphos Poisoning- A Case Report

Abstract

Aluminium phosphide is used to control rodents and pests in grain storage facilities. It is readily available as a fumigant for stored cereal grains and sold under various brand names such as QuickPhos, Salphos and Celphos. It acts by causing cellular hypoxia by its effect on mitochondria, causing inhibition of cytochrome C and by free radicals induced injury with no available antidote. Aluminium phosphide affects various systems, more commonly causing gastrointestinal tract irritation causing marked abdominal pain, shock with refractory hypotension  by direct toxicity to heart and various arrythmias, acute respiratory distress syndrome and respiratory failure. Less common features include hepatotoxicity, intravascular haemolysis with methemoglobinemia and/or renal failure. Here we present a case of 24-year-oldnon-alcoholic male, with history of ingestion of approximately6grams of Celphos. At presentation he was drowsy with 2 episodes of vomiting immediately after ingestion of toxin. On subsequent investigations patient was found to have acute pancreatitis which responded to standard fluid resuscitation and acute kidney injury for which 3 episodes of haemodialysis were required. His condition subsequently improved and did not require further dialysis. There have been only few case reports on aluminium phosphide poisoning primarily causing acute pancreatitis and acute kidney injury. In this case report, we present the case of a young man presented with consumption of aluminium phosphide and then developed acute pancreatitis and acute kidney injury without involvement of other organ systems including heart.