ENT manifestations of Kala Pathar poisoning; An experience at Nishter Hospital, Multan, Pakistan.


  • Muhammad Saleem Sheikh Nishtar Medical University, Multan.
  • Asim Shafique QMC & BUH, Bahawalpur.
  • Muhammad Hassan Nisar Nishtar Medical University, Multan.
  • Muhammad Sharif Shaid Nishtar Medical University, Multan.
  • Shahlla Majeed Nishtar Medical University, Multan.
  • Munaza Saleem Shifa International Hospital, Islamabad.




Black Stone Poisoning, Females, Suicide, Tongue Edema


Objective: To know the demographic representation along with possible ENT manifestations of Black Stone Poisoning. Study Design: Cross Sectional study. Setting: Emergency and Wards in Nishtar Hospital Multan. Period: April 2018 to December 2018. Material & Methods: The study was executed in total of 156 Patients with history of Black stone ingestion in Emergency and wards in Nishtar Hospital Multan. All included patients were having history of black stone ingestion along with ENT complications following black stone intake. All cases were excluded who were dead or unresponsive. Results: Most of the cases, 119 (76.3%) were females, between the age group of 11-20 years (41.66%) and 129 (82.7%) belonged to rural areas. Out of 156 subjects, 137 (87.8%) ingested black stone with intentions of suicide. It was noted that 102 (74.4%) patients ingested black stone due to family related issues. Most common ENT manifestations were hoarseness of voice in 149 (95.5%), uvula and pillars edema in 143 (91.7%), tongue edema in 140 (89.7%) and neck swelling in 131 (84.0%). Conclusion: Women more than men, young people more than any of the other ages, rural population more than urban and people living in stressful environment are prone to Black stone ingestion. Lips and tongue edema, neck swelling, odynophagia, vestibulitis, limited mouth opening, ulceration of buccal and nasal mucosa and epistaxis are the commonest ENT manifestations of black stone poisoning.

Author Biographies

Muhammad Saleem Sheikh, Nishtar Medical University, Multan.

MBBS, FCPS, Professor & HOD ENT, 

Asim Shafique, QMC & BUH, Bahawalpur.

FCPS, Associate Professor ENT, 

Muhammad Hassan Nisar, Nishtar Medical University, Multan.

FCPS, Senior Registrar ENT, 

Muhammad Sharif Shaid, Nishtar Medical University, Multan.

FCPS, Senior Registrar ENT, 

Shahlla Majeed, Nishtar Medical University, Multan.

FCPS, Women Medical Officer ENT, 

Munaza Saleem, Shifa International Hospital, Islamabad.

MBBS, House Officer Gynae & Obs,