Potentially fatal ingestion of heat-not-burn cigarettes successfully treated by gastric lavage

Newly introduced heat-not-burn or electronic cigarettes can cause lethal nicotine intoxication if ingested at higher doses. Although routine gastric lavage is not recommended, it should be considered if the amount of intoxicant is lethal. A 59-year-old man with a history of depression was brought to our emergency department after intentional ingestion of 8 heat-not-burn cigarettes, which were estimated to contain a total of 100 mg of nicotine. Abdominal computed tomography confirmed the gastric contents, detecting multiple stick-like and rod-shaped high-density structures. Gastric lavage was performed to minimize absorption of the potentially lethal nicotine dose. The patient exhibited only mild gastrointestinal symptoms. Emergency physicians should be aware of this novel heat-not-burn cigarette and its toxicity.