Clinical and Experimental Gastroenterology (Jul 2021)
The Ominous Ouzo Party – A Case Series of Four Patients with Accidental Alkali Ingestion
Abstract
Marcel Vetter1 12 2, Timo Rath1 12 2, Jürgen Siebler1 12 2, Maximilian Waldner1 12 2, Markus F Neurath1 12 2, Lukas Pfeifer3 3 1Department of Medicine 1, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; 2Deutsches Zentrum Immuntherapie, DZI, Erlangen, Germany; 3Department of Gastroenterology and Interventional Endoscopy, Krankenhaus Barmherzige Brüder, Regensburg, GermanyCorrespondence: Lukas PfeiferDepartment of Gastroenterology and Interventional Endoscopy, Krankenhaus Barmherzige Brüder, Prüfeninger Straße 86, Regensburg, Bavaria, 93049, GermanyTel +49 941 369 2051Fax +49 941 369 2055Email [email protected]: Ingestion of alkaline fluids is a common problem, which can lead to perforations, strictures and malignancy. We present a rare case series of several patients who accidentally ingested the same alkaline substance in different doses.Methods: We investigated four patients with accidental ingestion of dishwashing liquid. All patients underwent gastroscopy within 24h after inpatient admission. Gastroesophageal lesions were classified according to the Zargar classification for corrosive ingestions.Results: Esophagogastric lesions were predominantly found at the distal esophagus and the small curvature of the stomach. The severity of these lesions ranged from mild erosions (Zargar 2A) to marked necrosis (Zargar 3A). Our data suggest that the degree of these lesions correlated with the amount of ingested toxin and duration of the inpatient stay. However, a low symptom severity or inconspicuous otolaryngologic examination did not exclude severe gastroesophageal lesions.Conclusion: Our data suggest that the severity of gastroesophageal lesions correlates with the amount of ingested alkaline substance. Symptom burden and an otolaryngologic examination are not sufficiently predictive for the severity of gastroesophageal lesions. The composition and quantity of the swallowed liquid should be determined.Keywords: alkali ingestion, gastroscopy, toxin dose, case series
