Bronchiolitis and inhalation edema caused by dynamite explosion accident in a Colombian gold mine. Report of two cases.

Bronquiolitis y edema por inhalación causados en accidente por explosión de dinamita en una mina de oro en Colombia. Reporte de dos casos

Inhalation of particles released by an explosion can trigger multiple respiratory conditions due to the inhalation of simple asphyxiants such as carbon dioxide, irritating gases or chemical asphyxiants such as cyanide, nitrogen oxides or carbon monoxide (CO). Bronchiolitis obliterans is the most frequent histological form of bronchiolitis caused by the inhalation of a toxic substance, either a gas or inhaled particles small enough to enter the respiratory tract of less than 2mm in diameter and that is triggered by alterations in the tissue repair mechanism that generate inflammatory processes and even pulmonary fibrosis. Initially, we present the case of a patient who inhaled particulate material inside a gold mine after the dynamite explosion, he developed respiratory distress syndrome with severe hypoxemic failure that, at first, had an adequate recovery but, a week later, he was readmitted with ventilatory failure and was finally discharged with histopathological diagnosis of bronchiolitis obliterans. We also present another case in the same accident due to the detonation of dynamite which developed chemical pneumonitis due to inhalation of toxic gases and developed pulmonary edema due to inhalation. This patient had a more favorable outcome than his partner's. In the report of both cases, it was shown that in the same detonation, there were two pulmonary affections due to inhalation with toxic substances one triggered by the particulate material and the other by the gases released with different outcomes in two patients of similar age and background.