A 41-year-old man, PB, presented to the emergency room with severe stomach pain, vomiting blood, and black, tarry stools. He had a history of stomach ulcers, but the medical team discovered that his wife, Katie, had been secretly pouring drain cleaner into his coffee, causing caustic burns to his mouth, esophagus, and stomach. The drain cleaner, containing sodium hydroxide, reacted with the fatty acids in PB's cells, causing saponification and damaging his tissues. The medical team found a stricture in his lower esophagus, indicating that the caustic injury had occurred before. PB's condition worsened, and his organs began to shut down due to a perforated GI tract, which was caused by the drain cleaner. During surgery, doctors found a caustic burn at the site of the perforation, confirming that the drain cleaner was the cause. PB recovered from his physical injuries, but his marriage was beyond repair.
Here are the key facts extracted from the text:
1. A 41-year-old man, PB, presented to the emergency room with vomiting blood.
2. PB had a history of stomach ulcers and had been experiencing abdominal pain and black, tarry stools.
3. PB's wife, Katie, had been pouring drain cleaner into his coffee on multiple occasions.
4. The drain cleaner contained sodium hypochlorite, sodium chloride, and sodium hydroxide, which are highly caustic substances.
5. PB's esophagus was swollen, inflamed, and filled with ulcers, consistent with caustic injury.
6. PB's lower esophagus had started to narrow and close up, a condition known as a stricture.
7. PB's liver and kidneys were shutting down due to the caustic injury.
8. Doctors found a large volume of free fluid and gas in PB's abdomen, which was not supposed to be there.
9. The gas was likely produced by gut bacteria, and the fluid was likely stomach acid and food.
10. PB's immune system was reacting to the bacterial load flowing out of his gut, causing inflammation and organ shutdown.
11. PB underwent surgery, which revealed a caustic burn where the perforation happened.
12. The drain cleaner was determined to be the cause of PB's stomach contents leaking out into his abdomen.
13. PB's marriage to Katie was strained, and she had been pouring drain cleaner into his coffee as a form of revenge.
14. PB made a recovery in the hospital, but his marriage did not survive.