Lye injuries of the esophagus

Borja, Alonzo R.; Ransdell, Herbert T.; Thomas, Thomas V.; Johnson, William

doi:10.1016/s0022-5223(19)42705-0

Cited by 52 publications

(3 citation statements)

References 12 publications

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“…We have not reported in detail the relationships between the findings on physical examination and EGD. Our data are in keeping with the impression that absence of oropharyngeal lesions does not exclude esophageal or gastric mucosal disease (5–7). We had patients with normal findings on oropharyngeal examinations and grade 2 and 3 mucosal injury.…”

Section: Discussionsupporting

confidence: 89%

“…The indications for EGD in the evaluation of children with caustic ingestions are debated. It is generally agreed that the absence of oropharyngeal lesions does not completely exclude esophageal or gastric mucosal injury (5)(6)(7). Symptoms reported after caustic ingestion include nausea, vomiting, dysphagia, refusal to drink, drooling, abdominal pain, and stridor.…”

mentioning

confidence: 99%

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Is Esophagogastroduodenoscopy Necessary in all Caustic Ingestions?

Gupta,

Croffie,

Fitzgerald

2001

J. pediatr. gastroenterol. nutr.

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BackgroundIt is unclear whether symptoms alone can identify patients with caustic ingestion who will benefit from esophagogastroduodenoscopy (EGD). The published data are contradictory. The purpose of the current study was to determine the relationship between initial symptoms and EGD findings in patients with caustic ingestion.MethodsChart review of all caustic ingestions who underwent EGD during a 4‐year period (December 1993 through November 1997).ResultsTwenty‐eight patients (15 girls; mean age, 2.7 years (range, 0.92–13.33) underwent EGD after caustic ingestion. Fourteen percent (4/28) of patients were asymptomatic, and findings on endoscopy were normal. Another 57% (16/28) had normal endoscopic findings, although all were symptomatic. Twenty‐nine percent (8/28) of patients had esophageal injury on EGD, and all were symptomatic. Esophageal injury was graded as 1 (mucosal erythema), 2 (superficial burns; noncircumferential) or 3 (deep burns; circumferential). The injury was grade 1 in three of eight patients and grade 2 in two; all had one symptom each. Grade 3 injury was found in three of eight patients: two had two symptoms (drooling and vomiting, drooling and stridor), and one had one symptom (dysphagia). All patients with grade 3 injury subsequently underwent esophageal dilations. Follow‐up information was secured for two of the three patients with grade 1 injury and both patients with grade 2 injury at 34.3 months (range, 24–50) after the ingestion, and all were asymptomatic. Of the 20 patients with absence of esophageal mucosal damage, follow‐up data were available for l5 patients at 37.2 months (range, 7–63) after the event and all were well.ConclusionsAll patients with clinically significant injury (grades 2 and 3) were symptomatic at initial assessment. No single symptom or combination of symptoms could identify all patients with esophageal injury. All asymptomatic patients had normal findings on endoscopic examinations. Esophagogastroduodenoscopy seems unnecessary in asymptomatic patients with alleged caustic ingestion. A larger, prospective study would be necessary to unequivocally answer this clinically important question.

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Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

Is Esophagogastroduodenoscopy Necessary in all Caustic Ingestions?

Gupta,

Croffie,

Fitzgerald

2001

J. pediatr. gastroenterol. nutr.

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“…The authors identified only one perforation in index endoscopy in the alkali group. No iatrogenic perforations occurred during endoscopic examinations, although this complication is mentioned in the literature [ 3 , 11 , 12 ]. This finding might be explained by the careful examination with small diameter endoscopes [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Ingestion of corrosive substances and the endoscopic role in assessing the severity of caustic injury

Simonovska¹,

Stefanovska²,

Babulovska³

et al. 2023

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Introduction The ingestion of caustic substances into the upper gastrointestinal tract is an unusual but potentially life-threatening problem. Aim To evaluate the most commonly ingested corrosive substances, and the endoscopic findings, complications, and final outcomes of caustic intake. Material and methods This cross-sectional study included 220 inpatient participants with corrosive poisonings during a 3-year period (2017–2019). Data from the national patient electronic system “My term” and from the “Poisoning information centre” at the University Clinic for Toxicology, Skopje were used. Demographic characteristics, type of corrosive substance, endoscopic findings by Kikendall classification, emerging complications, fatal outcome, and hospitalization were analysed. Data obtained were analysed with the SPSS software package, version 22.0 for Windows. Results During the period 2017–2019, out of 220 hospitalized cases with corrosive substance intake, 132 (60%) were with ingestion of acids, 19 (8.6%) with bases, 32 (14.6%) with bleaches, and 37 (16.8%) with other household products ( p = 0.3469). The mean age of patients was 49.89 ±19.86 years. The most severe endoscopy findings (high-grade injury) were significantly more often associated with acid and base ingestion ( p = 0.00001). Out of all strictures, 25 (64.1%) were on one location (either oesophagus or stomach), and 12 (30.8%) were on 2 locations. Conclusions Upper gastrointestinal endoscopy is very important procedure for rapid assessment of severity of caustic injury, early appropriate therapy, as well as the potential development of strictures. The obtained data are very important for the development of a national program for the prevention of corrosive poisoning in our country.

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Caustic Injuries of the Esophagus

Spiegel

2012

The Esophagus

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Lye injuries of the esophagus

Cited by 52 publications

References 12 publications

Is Esophagogastroduodenoscopy Necessary in all Caustic Ingestions?

Is Esophagogastroduodenoscopy Necessary in all Caustic Ingestions?

Ingestion of corrosive substances and the endoscopic role in assessing the severity of caustic injury

Caustic Injuries of the Esophagus

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