CASE REPORT article
Front. Toxicol.
Sec. Clinical Toxicology
Delayed Gastrointestinal Structural Complications Requiring Surgery Following Massive Paint Thinner Ingestion in an Adult
Hyunwoo Sun 1
Hayeon Lee 1
Haewon Lee 1
Min Chang Kang 1
Eunhae Um 2
1. Uijeongbu Eulji Medical center, Uijeongbu, Republic of Korea
2. Inje University Ilsan Paik Hospital, Goyang-si, Republic of Korea
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Abstract
Background: Paint thinners, which contain volatile aromatic hydrocarbons like toluene and xylene, are primarily associated with acute systemic toxicity (e.g., central nervous system depression, metabolic acidosis) following inhalation. Case reports detailing severe, delayed gastrointestinal (GI) structural complications in adults after massive oral ingestion, which necessitate extensive surgical intervention, remain exceedingly rare in the medical literature. Case Description: A 68-year-old male with a history of hypertension and chronic alcoholism presented 8 hours after mistakenly ingesting approximately 500ml of paint thinner while intoxicated. On admission, the patient exhibited stupor, hypotension (74/49 mmHg), bradycardia (75 bpm), hypothermia (34.0°C), and significant hematochezia. Though systemic symptoms stabilized after initial intensive care, he developed recurrent, refractory episodes of ileus over the following three weeks, despite conservative management. Abdominal computed tomography (CT) scans revealed multisegmental wall thickening and lumen stricture in the distal jejunum and ileum, suggestive of enteritis or inflammatory bowel disease. Surgical exploration on Hospital Day (HD) 27 confirmed the progression to irreversible structural damage, revealing severe adhesion, a continuous global stricture in the terminal ileum (extending approximately 80 cm from the ileocecal valve), a skip lesion stricture proximally, and a suspected ileocecal fistula. An ileocecectomy was performed after resection of a 132 cm segment of small bowel. Pathology confirmed chronic, transmural inflammation and ulceration. Conclusions: This case demonstrates that massive oral paint thinner ingestion can bypass typical protective mechanisms, leading to severe, delayed, and localized structural GI failure, particularly in the terminal ileum. In patients who present with progressive mechanical sequelae (refractory ileus and hematochezia) following massive hydrocarbon ingestion, a high index of suspicion for developing chronic structural lesions is warranted, suggesting that timely surgical intervention may be critical to expedite patient recovery.
Summary
Keywords
Drug intoxication, Gastrointestinal stricture, Hydrocarbon toxicity, Paint Thinner Ingestion, surgical management
Received
06 October 2025
Accepted
18 February 2026
Copyright
© 2026 Sun, Lee, Lee, Kang and Um. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Hyunwoo Sun
Disclaimer
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