Abstract
Alkyl nitrites are volatile liquids with multiple uses. They are sometimes used prior to sex and referred to as poppers.
Alkyl nitrites are vasodilators, causing decreased blood pressure, tachycardia, headache, and relaxation of involuntary muscles. Alkyl nitrites also oxidize ferrous iron in haemoglobin to ferric iron, forming methaemoglobin which reduces the oxygen carrying capacity of blood, causing cyanosis.
It is reversed by the antidote methylthioninium chloride (methylene blue). These signs and symptoms of nitrite toxicity are well described, and may be life threatening due to severe cellular hypoxia, metabolic acidaemia and shock.
Although alkyl nitrite poppers are generally inhaled. They are rarely accidentally ingested, which is associated with severe methaemoglobinaemia and systemic toxicity.
We present a case of methaemoglobinemia and severe oesophageal injury after accidental ingestion of the alkyl nitrite preparation called Rush.