Text Box: HEMORRHAGIC GASTRITIS INDUCED BY HYDROGEN PEROXIDE
Wu TC, Wang KS, Huang IF, Lai MK
Division of Gastroenterology and Nutrition, Children’s Medical Center, Taipei-Veterans General Hospital, Taipei

Objective: Hydrogen peroxide had been used in the endoscopic procedure. Some studies suggest that 3% hydrogen peroxide can enhanced clot dissolution provided endoscopic visualization in the patients with acute upper GI bleeding. In our hospital, there was a boy who misswallowed bleach, the major contents is 5% hydrogen peroxide, and severe hemorrhagic gastritis was noted. So, we designed this study to evaluate the effect of hydrogen peroxide to stomach.
Methods: Ten Balb/c female mice were treated with 0.3ml 3% H2O2, 1.0% H2O2, 0.3% H2O2, bleach (5% H2O2), 1N HCl, 1N NaOH, and normal saline intragastrically. Thirty minutes later, animals were sacrificed. Gross appearance of stomach was observed, and then the specimen was prepared for further histologic examination.
Results: The gastric mucosa was all damaged in all different concentration of hydrogen peroxide. In lower concentration of hydrogen peroxide, the gastric mucosa revealed focal gastric erosion, with some small bleb in mucosa layer. The degree of damage is more severe when the concentration is increased. In 3% hydrogen peroxide and bleach, diffuse whole layer necrosis, intramural bleb, and severe congestion or hemorrhage was noted. 
Conclusion: Hydrogen peroxide is a caustic agent to stomach. In pediatric patient, the use of hydrogen peroxide in the endoscopic procedure is not recommended.
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