Intentional cyanoacrylate ingestion: A rare cause of delayed gastric perforation requiring gastric wedge resection.

Cyanoacrylate (LOCTITE® 401™) is a fast-acting adhesive available nationwide, with medical and household uses. Most cases of cyanoacrylate exposure are accidental and occur in children less than 5years old. Various routes of exposure have been reported including the dermal, oral, ocular, otic, nasal, and urethral routes; however, very few result in serious complication and mortality. Although a few cases of airway obstruction related to cyanoacrylate ingestion have been reported, intentional cyanoacrylate ingestion-induced gastrointestinal tract injury has scarcely been reported. In addition, there have been no reports of serious complications following intentional cyanoacrylate ingestion requiring surgical intervention. Herein, we report a case of intentional ingestion of cyanoacrylate in a 70-year-old man who required gastric wedge resection due to delayed gastric perforation.

Sticky situations: cyanoacrylate exposures reported to a poison control system.

INTRODUCTION: Cyanoacrylate (Super Glue®) exposures are commonly reported to poison control centers, but little has been published in the medical literature regarding these exposures. We sought to characterize cyanoacrylate exposures reported to a poison control system. METHODS: We performed a retrospective review of a poison system's database for all cases of single-substance human exposure to cyanoacrylate-containing products from 2005 to 2015. Data collected included age, gender, route of exposure, clinical effects, treatments recommended and medical outcome. RESULTS: There were a total of 893 patients, 505 (56.6%) of which were female. Patient ages ranged from 6 months to 88 years with a median of 11 years. The vast majority of exposures (n = 871, 97.5%) were unintentional, but a small number of exposures (n = 22, 2.5%) were due to intentional misuse (such as trying to stop a bleeding cut) or malicious intent (such as purposefully gluing a person's eyes shut as a prank). Routes of exposure included: ingestion, n = 337 (37.7%); ocular, n = 322 (36.1%); dermatologic, n = 285 (31.9%); inhalation, n = 16 (1.8%); nasal, n = 1 (0.1%); and otic, n = 1 (0.1%); some patients had multiple routes of exposure. Treatments recommended by the poison center included irrigation (n = 411), petroleum jelly (n = 143), mineral oil (n = 131), topical antibiotic ointment (n = 82), peanut butter (n = 6), acetone (n = 4) and WD-40® (n = 2). A total of 657 patients (73.6%) were managed on-site, while 236 (26.4%) were seen in a health care facility. Among all exposures, effects were classified as none (n = 287), minor (n = 529) and moderate (n = 77). No major effects or deaths were reported. CONCLUSIONS: In this case series, the majority of cases occurred in children and most exposures did not result in significant morbidity. Notably, there was wide variation in terms of recommended treatments; further study is needed to determine the optimal treatment method and to standardize poison center recommendations for treating patients with cyanoacrylate exposures.

Tracheal and bronchial obstruction following cyanoacrylate aspiration in a toddler.

INTRODUCTION: Cyanoacrylates are a common class of household substances used as adhesives and are commonly sold under brand names such as Super Glue, Krazy Glue, and others. We are reporting a case of accidental cyanoacrylate adhesive aspiration by a toddler complicated by tracheal and bronchial obstruction. CASE REPORT: A toddler ingested a low-viscosity cyanoacrylate product and developed a severe, persistent cough. Initial vital signs, oxygen saturation, lung sounds, and chest radiograph were unremarkable. Rigid bronchoscopy was performed and several pieces of glue were removed from both main stem bronchi. The child made a full recovery after a 10-day hospital stay. DISCUSSION: Cyanoacrylate ester polymers are hard, glassy resins that exhibit excellent adhesion to a variety of materials. Aspiration of these products is a poorly described clinical entity. CONCLUSION: The low viscosity of cyanoacrylate adhesive formulations makes aspiration of these products a rare but potentially life-threatening exposure. Management centers upon supportive care and consideration of rigid bronchoscopy for removal of adherent glue.

Accidental cyanoacrylate glue ingestion.

Cyanoacrylates have a variety of medical and commercial applications as adhesives. They are commonly found as glue in the household. They can be swallowed accidentally by children. However, no case was reported so far in the English medical literature. Their effect on the mouth, pharynx, larynx, esophagus and the rest of gastrointestinal system is unknown. Here we report our own child who accidentally ingested cyanoacrylate glue without unwanted sequelae due to prompt intervention.

Toxicity of cyanoacrylate adhesives and their occupational impacts for dental staff.

Cyanoacrylate (CA) and its homologues have a variety of medical, dental and commercial applications as adhesives. The increasing use of CA in dentistry, particularly as an adhesive and sealing glue, has raised concerns regarding its potential toxicity in humans. Reported toxicity of CA is uncommon in the dental workplace, but may manifest as conditions such as urticaria, contact dermatitis and other dermatoses. Dental staff using CA adhesives should avoid direct contact with CA and use appropriate personal protective measures. Maintaining higher levels of humidity, optimizing room ventilation and using special air conditioning filters in the working environment may be useful in minimising the toxicity of volatile CA adhesives.