Caustic ingestion: Has the role of the gastroenterologist burnt out?

Gill, Madeleine; Tee, Derrick; Chinnaratha, Mohamed Asif

doi:10.1111/1742-6723.13278

Cited by 12 publications

(13 citation statements)

References 9 publications

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“…A chest X-ray and abdominal film may be useful in the acute phase to look for stigmata of perforation, such as peritoneal or mediastinal free air or pleural effusion (Caravati 2014;de Lusong et al 2017). CT-scan may also be useful for such purposes (Caravati 2014;Contini and Scarpignato 2013;Jagpal et al 2014;Gill et al 2019). The best method for determining the severity and location of tissue injuries is EGD with a flexible fiberoptic scope which should be performed in the initial 12-24 h, as later evaluations carry a greater risk of perforation (Caravati 2014;Wax and Yarema 2007;Lupa et al 2009).…”

Section: Clinical Aspects Of Corrosive Substances Ingestionmentioning

confidence: 99%

“…These authors concluded that CT-scan and endoscopy findings correlation as pertains to injury grading is not sufficient to preclude the need for endoscopy (Bahrami-Motlagh et al 2017). Other authors have stated that esophageal and gastric CT-scan is better than traditional endoscopy for the purpose of triaging patients for emergent surgical intervention or observation (Chirica et al 2017;Methasate and Lohsiriwat 2018) and for assessing the risk of stricture formation (Gill et al 2019). Bruzzi et al (2018) compared the accuracy of CT-scan versus endoscopy in the acute evaluation of 152 adult patients at risk of developing esophageal stricture formation following corrosive chemical substance ingestion.…”

Section: Comparison Of Endoscopy and Chest/abdominal Ct-scanmentioning

confidence: 99%

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Corrosive substances ingestion: a review

Hall

Jacquemin²,

Henny³

et al. 2019

Critical Reviews in Toxicology

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Corrosive chemical substance ingestions are a major problem, especially in developing countries, but also in developed countries such as the United States, France, and Belgium. Ingestions may be deliberate as suicide attempts (mostly in adolescents and adults) or accidental (mostly in children). The results can be devastating in terms of individual suffering and disability, but also in terms of resource utilization and costs. In developing countries, outcomes may be worse because of limited medical/surgical resources. Common sequelae include gastrointestinal (GI) tract (esophagus, stomach, pylorus, and duodenum) stricture formation, GI tract perforation, and hemorrhage. Systemic effects may also occur, such as disseminated intravascular coagulation (DIC), multi-organ system failure, and sepsis. Various interventions in the acute phase to reduce the severity of injury have been attempted, but there are no large controlled clinical trials to demonstrate efficacy. Dilation therapy in various forms is commonly used for the treatment of strictures and a variety of surgical procedures including esophagectomy and delayed replacement may be required in severe corrosive injury cases.

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Section: Clinical Aspects Of Corrosive Substances Ingestionmentioning

confidence: 99%

Section: Comparison Of Endoscopy and Chest/abdominal Ct-scanmentioning

confidence: 99%

Corrosive substances ingestion: a review

Hall

Jacquemin²,

Henny³

et al. 2019

Critical Reviews in Toxicology

View full text Add to dashboard Cite

show abstract

“…From 70% to 90% of patients would not require immediate surgery (i.e. esophageal or gastric resection) as the lesion are below 3a grade according to Zargar classification [2]. The most common complication is stenosis that regularly develops during the first 2 months after ingestion and it should be treated by endoscopic dilatation [3].…”

Section: Santiago Camachomentioning

confidence: 99%

“…Thus, unfortunately there is no specific treatment that allows adequate recovery in these patients who will have a low quality of life and malnutrition associated with the mechanical dysphagia due to stenosis [3]. It is in this context that research is needed on new agents that eliminate or reduce the stenosis secondary to inflammation by the ingestion of caustics, especially in the esophagus; the most affected organ in these cases [2]. There are some approaches in animal models (i.e.…”

Section: Santiago Camachomentioning

confidence: 99%

Research in Basic Sciences Is Essential for Creating New Ideas for Practice and Learning of Surgery

Camacho

2019

Journal of Investigative Surgery

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“…Moreover, pediatric cases constituted 44.1% of total admitted cases during 2009 to 2013 year and 26.3% of them suffered from acute caustic ingestion (Azab et al, 2016). Stricture formation is the most common and disabling long-term complication of corrosive ingestion (Gill et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Is Multi-detector Computed Tomography an Early Predictor for Esophageal Injury Following Acute Caustic Ingestion?

Manal

et al. 2022

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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Background: Caustic ingestion is considered severe condition with poor outcome that mandate early diagnosis to improve the management. Although endoscopy is considered the gold standard of diagnosis worldwide, some authors urge caution in developing treatment plans for patients with caustic ingestion based only on endoscopic findings. Besides, it is not considered as routine management at Ain Shams University hospitals. Recent studies suggests that computed tomography (CT) scan can accurately predict risk of stricture formation and also guide towards more judicious use of surgical management. Aim of the Work: Evaluating the role of Multi-detector Computed Tomography (MDCT) as an early predictor for esophageal injury following acute caustic ingestion and comparing MDCT grading system and DROOL score, for patients with acute caustic ingestion. Subjects and Methods: A prospective cohort study carried out on 50 pediatric patients admitted to Poison Control Center-Ain Shams University Hospitals (PCCASUHs) with history of corrosive ingestion within 24 hours post ingestion. Results: In the current study, (25.6%) of the patients included in the current study had esophageal injury while (74.4%) of them had no esophageal injury. DROOL score (≤ 4) could predict the development of esophageal injury with sensitivity of (90.9%), specificity of (81.2%) and accuracy of (83.7%),(62.5%) positive and (96.3%) negative predictive values. Also CT grades III and IV could predict the development of esophageal injury with sensitivity of (90.9%), specificity of (87.5%) and accuracy of (88.4%), (71.4%) positive and (96.6`%) negative predictive values. AUC for CT grading system (AUC = 0.88) was larger than that for the DROOL scoring system (AUC =0.83). CT grading system had higher specificity and accuracy than DROOL score. Conclusion and Recommendations:The current study concluded that CT grading system can be used as an early predictor for esophageal injury following acute caustic ingestion. It is recommended to evaluate the esophageal injury by doing MDCT for all cases admitted with caustic ingestion even those with mild signs and symptoms.

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Caustic ingestion: Has the role of the gastroenterologist burnt out?

Cited by 12 publications

References 9 publications

Corrosive substances ingestion: a review

Corrosive substances ingestion: a review

Research in Basic Sciences Is Essential for Creating New Ideas for Practice and Learning of Surgery

Is Multi-detector Computed Tomography an Early Predictor for Esophageal Injury Following Acute Caustic Ingestion?

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