An overview of corrosive injury of the upper gastrointestinal tract: Discussion of types, clinical evaluation, and management procedures

Abstract

Corrosive substances continue to have an impact on the morbidity of children and adolescents in developing countries despite the intensive and extensive education programs directed at susceptible groups, legislations controlling the strength and handling of these substances, and preventive measures of labeling and packaging. The greatest impact is on children between 1 and 3 years of age. Oral lesions are not predictors of either the extent or the severity of the caustic lesion. Upper endoscopy is the cornerstone of the evaluation of the extent of the gastrointestinal injury. Upper endoscopy intervention, including early evaluation, stent insertion, and, stricture dilatation, is subject to discussion and debate.

A new perspective of the risk of caustic substance ingestion: the outcomes of 468 patients in one North Taiwan medical center within 20 years

“…Perforation is always considered the most critical complication in clinical situations [1,2,8,9,11,18,24,29]. Cheng et al [3] emphasized the importance of early EGD classification to identify patients with grade 3b injuries, which predicted perforation.…”

“…Conversely, the consensus is that caustic tissue damage simultaneously depends on the type of substance, commercial formulation, pH, dose, concentration, viscosity, duration of contact, and the concept of titratable acid/alkaline reserve [1][2][3][6][7][8]11,[18][19][20][21][22][23][24]. However, exact information is difficult to obtain [1,8,11].…”

<p>The Association Between Caustic Ingestion and Psychiatric Comorbidity Based on 396 Adults Within 20 Years</p>

“…The incidence of caustic ingestion varies from country to country. 1,2,[5][6][7]10,13,14,17,19 Although possibly underreported, 10,12,19 the annual incidence rate of caustic ingestion in Taiwan was estimated as 4.3 per 100,000 adults by the Taiwan National Health Insurance Research Database (NHIRD). 4 With our 396 cases with PCs and 377 controls, our study enrolled 4% of adult cases in Taiwan.…”

“…[1][2][3][4][5][6][7][8][9] The extent of damage depends on the chemical properties, amount, concentration, and physical form of the ingested substances. [1][2][3]5,6,[10][11][12][13][14] Patient age, sex, comorbidities, complications, treatment choices, and socioeconomic status have important roles in survival outcomes and postinjury quality of life. 1,2,4,6,7,12,13,[15][16][17][18][19][20][21] Preventive measures have been widely advocated.…”

“…1,4,5,10,17,25 The associated factors include socioeconomic problems, marital/interpersonal conflicts, low educational status, and negligence in handling caustic substances. 14,16,[23][24][25][26][27][28][29] The high prevalence of psychiatric comorbidities (PCs) has been widely reported among caustic injury victims. 4,10,11,[16][17][18][19]25,27,28,30,31 Nevertheless, the effect of PCs on the clinical features and prognostic outcomes remains unclear because of limited information and scarce reports on long-term prognoses.…”