Hydrocarbon ingestion

• Because of their low viscosity and high volatility, hydrocarbons may be aspirated during ingestion and cause a secondary pneumonitis, although most children who ingest hydrocarbons do not develop respiratory difficulties.
• onset of respiratory symptoms and radiographic findings may be delayed.
• Patients who are asymptomatic after 6 hours of observation and have negative radiographic findings are unlikely to develop symptoms.
• Those who do develop clinical pneumonitis may experience dyspnea and hypoxia and require oxygen treatment.
• Occasionally, ventilatory assistance is necessary.
• Rarely, there is a rapid  progression to respiratory failure and death.
  
   
• Acute complications of pneumonitis include pneumothorax, subcutaneous emphysema of the chest wall, and pleural effusions.
• A secondary pneumonia may develop during the ensuing week.
• Pneumatoceles may be a late development, but they rarely require treatment.
• Most children survive hydrocarbon pneumonitis without complications or sequelae. 
• They are at risk for obstructive pulmonary disease, although results of long-term pulmonary function studies have been inconclusive. 
  
   
• Although ingestion of hydrocarbons may cause acute gastrointestinal irritation: esophagitis and subsequent esophageal stricture are not expected.
• Ingestion of corrosive household cleaning products is associated with acute esophagitis and long-term development of strictures.
  
  Pulmonary hemorrhage has not been described in hydrocarbon pneumonitis. Chronic inhalation abuse or "huffing" has been associated with the sequelae of cardiomyopathy and encephalopathy. An acute effect of inhalant abuse can be death due to cardiac arrhythmia.
  
  References:
  Klein BL, Simon JE. Hydrocarbon poisonings. Pediatr Clin North Am.
  1986;33:411-419
  Orenstein DM. Aspiration pneumonias and gastroesophageal
  reflux-related respiratory disease. In: Behrman RE, Kliegman RM,
  Jenson HB, eds. Nelson Textbook of Pediatrics. 16th ed. Philadelphia,
  Pa: WB Saunders Co; 2000:1289-1290