Ji Yung Choo MD, Abstract Co-Author: Nothing to Disclose

Ki Yeol Lee MD, PhD, Abstract Co-Author: Nothing to Disclose

JungWon Kwak, Presenter: Nothing to Disclose

Sung-Joon Park MD, Abstract Co-Author: Nothing to Disclose

Je Hyeong Kim, Abstract Co-Author: Nothing to Disclose

Eun-Young Kang MD, Abstract Co-Author: Nothing to Disclose

Whan Oh, Abstract Co-Author: Nothing to Disclose

Hydrogen chloride (HCL) is a colorless, irritating and corrosive gas and vary widely used in the industry. Because of its strong acidity, it is easy for people to misunderstand that HCL inhalation is always significantly fatal. Despite of its general use, no imaging features after inhalation exposure have been previously described. In the present study, we analyzed high-resolution computed tomography findings of HCL inhaled lung injury and reviewed its pathophysiology through literature review.

Seven patients (24 to 65 years, mean age, 41.9 years) inhaled HCL vapor on their occupational working process dealing with HCL. We retrospectively reviewed clinical symptoms, initial blood gas analysis and pulmonary function test as well as serial HRCT findings.

HCL inhaled lung injury showed 3 patterns of HRCT findings; bilateral symmetric consolidation and GGO with interstitial thickening in central portion suggesting permeability pulmonary edema, irregular linear abnormalities or centrilobular nodules in both lower lungs. These abnormalities tended to grossly improve within one week after exposure. Centrilobular nodules with air trapping indicating bronchiolitis and bronchiectasis may remain as sequelae on follow up study after 3-6 months.

Airspace consolidation, followed by ground glass attenuation, interlobular septal thickening and centrilobular nodules were common on the initial CT scans. Serial follow-up CT scans included bronchiolitis obliterans, bronchiectasis and mosaic attenuation. It is meaningful that this study demonstrates the serial change in lung observed by CT after inhalation injury by HCL single gas.

It is meaningful that all patients were fully recovered without significant sequelae in current study, unlike aspiration pneumonitis of gastric acid.  

Choo, J, Lee, K, Kwak, J, Park, S, Kim, J, Kang, E, Oh, W, Inhalation Lung Injury by Hydrogen Chloride: Radiologic Spectrum with Serial Follow-up Study.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009883.html