What is the recommended treatment for glue ingestion?

Management of Glue Ingestion

Immediate Management: Do NOT Induce Vomiting or Give Oral Substances

For glue ingestion, immediately contact Poison Control and do NOT administer anything by mouth (water, milk, activated charcoal) or induce vomiting, as these interventions are contraindicated and may cause aspiration or worsen obstruction. 1, 2

The type of glue ingested determines the clinical approach and urgency:

Type-Specific Management Algorithm

Polyurethane/Wood Glues (Diphenylmethane Diisocyanate-Based)

These are the most dangerous glues requiring urgent surgical evaluation, as they expand 4-8 times their original volume within minutes to hours, forming obstructive gastric foreign bodies. 3

Immediate Actions:

• Contact Poison Control immediately 1
• Obtain abdominal radiographs within 4-6 hours of ingestion to detect the expanding "glue-ball" foreign body 3
• Do NOT induce emesis - this risks aspiration into the respiratory tree or esophageal impaction of the expanding mass 3
• Do NOT attempt dilution with liquids, activated charcoal, or bulk-forming products - these are ineffective 3
• Do NOT attempt endoscopic removal - this has proven unreliable 3

Clinical Monitoring:

• Watch for symptoms developing within 12 hours: anorexia, lethargy, vomiting, tachypnea, abdominal distention and pain 3
• Monitor for life-threatening complications: esophageal/gastric obstruction, airway obstruction, mucosal hemorrhage, ulceration, perforation 3

Definitive Treatment:

Surgical removal is the safest, most effective therapy and should be performed early for complete recovery. 3 As little as 2 oz can form obstructive masses requiring surgery 3. In reported cases, 8 of 14 required surgical intervention, with complete recovery when treated appropriately 4

Cyanoacrylate Glues (Super Glue)

Cyanoacrylate exposures typically result in minor effects and can usually be managed on-site without significant morbidity. 5

Management by Route:

Ingestion (37.7% of exposures):

• Most cases result in no or minor effects 5
• The glue polymerizes rapidly on contact with moisture but typically does not cause obstruction like polyurethane glues 6
• Supportive care and observation are usually sufficient 5

Ocular exposure (36.1% of exposures):

• Irrigation is the primary treatment 5
• Petroleum jelly or mineral oil may be recommended 5

Dermatologic exposure (31.9% of exposures):

• Treatment options include petroleum jelly, mineral oil, or topical antibiotic ointment 5
• Acetone has been used but should be approached cautiously 5

Outcomes:

• 73.6% managed on-site without healthcare facility visit 5
• No major effects or deaths reported in a series of 893 exposures 5
• Effects classified as none (32.1%) or minor (59.2%) in the vast majority 5

Other Household Glues (Paint Thinner-Based)

Follow general toxic ingestion protocols with emphasis on supportive care for multi-organ toxicity. 1

• Do NOT give water, milk, or activated charcoal unless specifically directed by Poison Control 1
• Do NOT induce vomiting - contraindicated with no clinical benefit 1
• Monitor for CNS effects (drowsiness, dizziness, agitation, coma) and GI manifestations (mucosal irritation) 1
• Activate EMS if life-threatening signs develop: altered mental status, seizures, respiratory difficulty, vomiting 1

Critical Pitfalls to Avoid

1. Never assume all glues are benign - polyurethane wood glues require urgent surgical evaluation while cyanoacrylates are typically minor 3, 5

2. Never delay imaging for suspected polyurethane ingestion - the mass forms within minutes and radiographs should be obtained within 4-6 hours 3

3. Never attempt home remedies or dilution for expanding glues - this is ineffective and delays definitive surgical treatment 3

4. Never induce vomiting for any glue ingestion - risk of aspiration and esophageal impaction outweighs any potential benefit 1, 3

5. Always contact Poison Control for specific guidance, as management varies significantly by glue type 1, 2