International Journal of Research in Medical Sciences | August 2019 | Vol 7 | Issue 8 Page 3180
International Journal of Research in Medical Sciences
Nadeem M et al. Int J Res Med Sci. 2019 Aug;7(8):3180-3182
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Case Report
Aluminium phosphide induced pancreatitis
Mir Nadeem
1
*, Vishal Phogat
1
, Mir Waseem
2
, Tabinda Ayub Shah
3
INTRODUCTION
Aluminium Phosphide (AlP) is a commonly used
agricultural pesticide. It is cheap, effective, and easily-
available.
Aluminium Phosphide is used as a rodenticide,
insecticide, and fumigant to pre-serve stored cereal
grains, also known as Wheat pills. In Iran it is known as
the rice tablet.
1
There have been frequent incidents of
accidental or intentional deaths. Since the first available
report of AlP poisoning in 1980s from India, it is now
one of the most common and lethal poisonings with no
available antidote.
Highly poisonous, aluminium phosphide has been used
for suicide.
2
It has been reported to be the most common
cause of suicidal deaths in North India.
3,4
The fatal dose has been reported as 0.5 g for a 70 kg adult
with a mean time interval between poisoning and death
ABSTRACT
Aluminium Phosphide (AlP) is a commonly used agricultural pesticide. It is cheap, effective, and easily available.
Aluminium Phosphide is used as a rodenticide, insecticide, and fumigant to preserve stored cereal grains, also known
as "Wheat pills". In Iran, it is known as the rice tablet. There, have been frequent incidents of accidental or intentional
deaths. There have been only a few case reports on aluminum phosphide-induced pancreatitis in the literature
available. In this report, we present the case of a young man who developed acute pancreatitis following ingestion of
aluminum phosphide pellet in the absence of the usual risk factors and after exclusion of other possible causes of
pancreatitis. 35-year-old male came to the ER of SGT Hospital, Gurugram, one hour after ingestion of a single 3 g
tablet of Aluminium Phosphide (Celphos) at home, with a suicidal intent. He had three episodes of Vomiting on the
way to the hospital. On Day 1 of admission, USG abdomen showed heterogeneity of head and the body of pancreas
with minimal peri-pancreatic fluid, suggestive of Pancreatitis. Serum Amylase and lipase levels were raised
throughout the hospital course. CT images were suggestive of pancreatitis. The signs and symptoms of Acute AlP
Poisoning are non-specific, dose dependent and evolve with time. After ingestion, toxic features usually develop
within a few minutes. The major lethal consequence of AlP ingestion is profound circulatory collapse, secondary to
direct effects of toxins on cardiomyocytes, fluid loss, and adrenal gland damage. Our patient was diagnosed with
acute pancreatitis in first 24hours of admission with high suspicion of pancreatitis and managed well with iv fluids
and supportive treatment and was discharged after 3 weeks of in hospital stay.
Keywords: Aluminium phosphide, Pancreatitis, Sepsis, Shock
1
Department of Medicine, SGT Medical College and Research Centre, Gurgoan, Haryana, India
2
Department of Medicine, GMC Baramulla, Jammu and Kashmir, India
3
Department of medicine GMC Srinagar, Jammu and Kashmir india
Received: 25 May 2019
Revised: 17 June 2019
Accepted: 03 July 2019
*Correspondence:
Dr. Mir Nadeem,
E-mail: mirnadeem44@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20193414