Retrospective Evaluation of Corrosive Substance Ingestion: Single Center Experience

Abstract

Introduction:Caustic substance ingestion is a serious problem due to high morbidity and mortality. Chemical products used in homes are the source of accidental or deliberate caustic exposures that can be seen in people of different ages. The severity of the lesions produced by the caustic substances in the tissue depends on the type, amount and concentration of the caustic agent taken, as well as the time of contact with the mucosa. In this article, we aimed to evaluate the demographic characteristics, endoscopic results, clinical findings and complications of our patients admitted to our university hospital for corrosive substance ingestion.Methods:We retrospectively identified adult patients admitted to our hospital between 2013-2019 for corrosive substance ingestion. We examined the endoscopy findings and endoscopy requirement within 24 hours of ingestion in 75 adult patients with acute corrosive substance ingestion.Results:Forty-three patients (57%) were female and 32 (43%) were male. The mean age of the males was 39.3±14.50 years and the mean age of the females was 34.1±16.91 years. Sixteen corrosive substance ingestions (21.3%) were suicidal and 59 (78.6%) were accidental. Thirty-seven patients (49.3%) were asymptomatic and did not require endoscopy and seven patients (9.3%) were recommended endoscopy but they did not consent. Fifteen patients (20%) had normal endoscopic findings, nine (12%) had Los Angeles (LA) grade A esophagitis, five (6.6%) patients had LA Grade B esophagitis, and one patient (1.3%) had LA grade D esophagitis due to crystal drain opener ingestion. One patient (1.3%) with history of thinner ingestion had esophageal polyp and Schatzki ring. Regarding corrosive substances, 25 patients (33.3%) had bleach ingestion. There was no mortality due to corrosive substance ingestion.Conclusion:Caustic substance ingestion is often inadvertent and is accompanied by mild symptoms or esophageal damage. Endoscopy may not be performed, especially in asymptomatic people with bleach or softener ingestion. In suicidal ingestions, serious injuries may occur because patients ingest too much, and endoscopy is indicated for suicidal ingestion. Endoscopy should be used only to evaluate esophageal and gastric injury and to determine prognosis. A careful psychiatric evaluation should be performed for suicidal ingestion.

Keywords

• caustic intoxication
• corrosive substance ingestion
• esophagitis