Aluminium phosphide (ALP) is a commonly available pesticide in agricultural countries.  It is a highly effective outdoor and indoor insecticide and rodenticide. Upon ingestion, this releases highly toxic phosphine gas in the gastrointestinal tract when it comes in contact with humidity.¹ ALP inhibits cytochrome oxidase, interferes with cellular respiration and induces severe oxidative stress. This leads to refractory shock, metabolic acidosis, arrhythmia, renal and hepatic failure. There is no antidote available and the treatment is mainly supportive.²

Keywords: Celphos poisoning, retained guidewire, Pneumothorax, clavicle segment removed.

1. N. Khosla, R. Handa, P. Khosla. Aluminium phosphide poisoning. Trop. Doct., 22(4) (1992),pp. 155-157.
2. Pangeni, R.K. Kc. Successfully managed case of Celphos poisoing: a case report and review. J Nepal Health Res Counc, 12(28) (2014), pp 200-202.
3. Choudhary A, Agarwal A, Dhiraaj S. An unusual case of guidewire impaction during internal jugular venous cannulation. Anesth Analg 2005;100:1217-8.

Dr Maninder Singh Raizada

Department of Anaesthesia, Dr. RPGMC Kangra at Tanda