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Death Following Injection Sclerotherapy Due to Phenol Toxicity


  • Abraham T. Philip M.D.,

    Corresponding author
    1. Onondaga County Medical Examiner's Office, Syracuse, NY
    • Additional information and reprint requests:

      Abraham T. Philip, M.D.

      Regional Medical Examiner's Office

      325 Norfolk Street

      Newark, NJ 07103


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    • Present address: Regional Medical Examiner's Office, 325 Norfolk Street, Newark, NJ 07103.
  • Jeanna M. Marraffa Pharm.D

    1. Upstate New York Poison Center, Syracuse, NY
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  • Presented at the 61st Annual Meeting of the American Academy of Forensic Sciences, February 16–21, 2009, in Denver, CO.


Prolapse rectum (PR) or protrusion of the rectum beyond the anus occurs frequently in populations at both extremes of age. In the pediatric population, in developed countries, the commonest cause for PR is thought to be cystic fibrosis (CF). Treatment options for CF include conservative management, surgical resection and fixation, suturing, and injection sclerotherapy (IS). The last is considered an attractive treatment option because it is minimally invasive. In this case report, the authors present the details about a 2-year-old female child, with PR and CF, who died after IS, using phenol as the sclerotherapeutic agent. Autopsy findings and toxicology tests performed to establish phenol toxicity are documented. The available literature is reviewed. This case report underscores the risks of using phenol for IS and emphasizes the point that the procedure is not innocuous and an adverse outcome including fatality is a possibility.