Stomach wash fluid in a case of corrosive acid ingestion (sulphuric acid) is positive for haemoglobin on testing. The mechanism of haemoglobin appearance in stomach washings after acid ingestion is:
- A Haemolysis of red blood cells by acid entering the portal circulation
- B Direct corrosive destruction of gastric mucosa with haemorrhage into the stomach lumen ✓
- C Acid neutralising gastric acid and causing peptic ulceration
- D Reflex haematemesis from vagal stimulation
Correct answer: B. Direct corrosive destruction of gastric mucosa with haemorrhage into the stomach lumen
Explanation
Strong mineral acids cause immediate coagulative necrosis of the gastric mucosa on contact. The direct corrosive action destroys mucosal cells and blood vessels, causing haemorrhage into the gastric lumen. This haemorrhagic gastritis produces haemoglobin in the stomach contents (coffee-ground or frank blood appearance). The process is local and mechanical, not a systemic haemolytic effect. Vagal stimulation can cause vomiting but not haemorrhage independently.
Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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