Formic acid (FA) being pungent, odorless, easily available and consumed for suicidal purposes and the dilute form being colorless and odorless is consumed accidentally. Accidental ingestion is rare and deliberate self-harm is very painful and violent which has been a rare modality of committing suicide but for these areas where it is easily available.

This a retrospective case series analysis study 14 patients with acute formic acid poisoning. There were 14 patients, with 3 females and 11 males. The average age was 35.5 years, with the average in males being 34.9 and 37.6 in females. Thirty milliliter were considered as cutoff range as diluted/undiluted FA below 30 ml were managed in our institution and 30 ml+ were referred to higher toxicology speciality care.

Act of deliberate self-harm was seen in 11 cases (78.5%) and accidental ingestion in three cases (21.5%). All had orofacial burns, 4 had mild hematemesis and 3 severe hematemesis with impending renal complications. All the stabilized and referred cases were no further evaluated for follow-up. Facial burns and contracture needing cosmetic correction was seen in three cases, while corneal and lid scarring seen in two cases while a case of esophageal stricture with lower GIT and renal complications were seen in one case.

Formic acid poisoning is uncommon, and limited literature review is available with fewer protocols laid. So, immediate management of this corrosive poisoning with supportive measures reduces the mortality drastically. Serial upper gastrointestinal imaging diagnose stricture earlier and cosmetic reconstruction helps in facial scarring and contractures.

Bhat RS, Naik SM, Goutham MK, Bhat CR, Appaji M, Chidananda KV, Devi NP, Joseph S, Nayak P. Acute Formic Acid Poisoning: A Case Series Analysis with Current management Protocols and Review of Literature. Int J head Neck Surg 2014;5(3):104-107.