A Newborn Case of Esophagus and Vocal Cord Burn After CS (O–Chlorobenzylindene Malononitrile) Gas Inhalation

Among the agents used for self-defense, O-chlorobenzylidene malononitrile (CS) is the most commonly used substance. It has been suggested that CS use is characterized by rapid onset of action, short duration of action, and minimal side effects. When the clinical situations and case series resulting from exposure to CS were examined, we saw that no cases of exposure during the neonatal period were identified. A male baby born at 40 weeks, weighing 3260 grams, was brought to the emergency room on the 24th postnatal day with bruising and respiratory distress due to a stranger spraying CS into his mouth. There was a widespread hyperemic erosive lesion in the mouth, tongue exfoliation, and leg ecchymosis. Widespread edema and hyperemia were observed in the vocal cords, and the patient was intubated and followed up. An epithelial defect involving the corneal limbus and conjunctiva was detected in the upper and lower eyelid membranes. Endoscopy revealed a grade 2 burn in the esophagus, and normal pseudomembrane and gastric mucosa in some areas. It was observed that the lesions around the patient's mouth and tongue completely resolved. After discharge, the esophagus-stomach-duodenum radiograph showed no suspicion of obstruction. At the 3rd-month post-discharge check-up, his eye examination was normal, and his stridor and wheezing at rest continued. This case, in which we have shown that CS used for self-defense or riot suppression, seriously threatens the life of a newborn patient for the first time and may perhaps cause permanent morbidities during follow-up, suggests the need to restrict access to such substances.

CS (O-Klorobenzilinden Maloonitril) Gazý Ýnhalasyonu Sonrasý Özefagus ve Vokal Kord Yanýðý Geliþen Bir Yenidoðan Vakasý

Kendini savunma amacýyla kullanýlan ajanlar arasýnda en sýk kullanýlan madde O-klorobenziliden malononitril (CS)'dir. CS kullanýmýnýn hýzlý etki baþlangýcý, kýsa etki süresi ve minimal yan etkilerle karakterize edildiði öne sürülmüþtür. CS maruziyeti sonucu ortaya çýkan klinik durumlar ve vaka serileri incelendiðinde yenidoðan döneminde herhangi bir maruziyet vakasýna rastlanmadýðýný gördük. 40 haftalýk doðan, 3260 gram aðýrlýðýnda erkek bebek, doðum sonrasý 24. günde yabancý birinin aðzýna CS sýkmasý sonucu morarma ve solunum sýkýntýsý þikayetiyle acil servise getirildi. Aðýzda yaygýn hiperemik eroziv lezyon, dilde eksfoliasyon ve bacaklarda ekimoz mevcuttu. Ses tellerinde yaygýn ödem ve hiperemi gözlenen hasta entübe edilerek takibe alýndý. Üst ve alt göz kapaðý membranlarýnda kornea limbusu ve konjonktivayý kapsayan epitel defekti tespit edildi. Endoskopide yemek borusunda 2. derece yanýk olduðu ve bazý bölgelerde normal psödomembran ve mide mukozasý olduðu görüldü. Hastanýn aðýz ve dil çevresinde oluþan lezyonlarýn tamamen düzeldiði görüldü. Taburculuk sonrasý çekilen yemek borusu-mide-duodenum grafisinde herhangi bir obstrüksiyon þüphesi görülmedi. Taburculuk sonrasý 3. ayda yapýlan kontrolde göz muayenesi normal olan hastanýn istirahatte hýrýltýsý devam ediyordu. Meþru müdafaa veya isyan bastýrma amacýyla kullanýlan CS'nin ilk kez yenidoðan bir hastanýn hayatýný ciddi þekilde tehdit ettiðini ve belki de takip sýrasýnda kalýcý morbiditelere neden olabileceðini gösterdiðimiz bu vaka, bu tür maddelere eriþimin kýsýtlanmasý gerektiðini düþündürmektedir. (SETB-2024-07-119)