Accidental aspiration of a 'bleach' tablet: BMJ case report
Sodium hypochlorite is a corrosive, highly alkaline (pka=7.52) household product. Ingestion of sodium hypochlorite liquid is common, showing toxicity on the oesophagus and stomach. Nevertheless, cases of sodium hypochlorite ingestions in pellet are rare and the management of them is unknown.

The authors report the case of a 65-year-old man who accidentally swallowed a bleach tablet of 3.5 g. Six hours later, the patient developed an aphonia associated with dysponea stage IV, motivating a nasofibroscopy showing glottis and supraglottic necrosis and oedema for which the patient received intravenous steroids, was intubated and then underwent a tracheotomy.

After 2 weeks under tracheotomy, local evolution was favourable allowing a removal of the cannula and a return back home.

Learning points
• Ingestion of sodium hypochlorite in undiluted pellet form is an uncommon but dangerous emergency department complain.

• In the absence of specific guidelines, management should be the same as for liquid form.

• Steroids and awake nasotracheal fibroscopic intubation should be considered for life-threatening laryngeal oedema.

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