Citation

Mirji P, Joshi C, Mallapur A, Vishwanath G, Emmi S. J. Clin. Diagn. Res. 2011; 5(5): 944-947.

Copyright

(Copyright © 2011, JCDR Prepublishing)

DOI

unavailable

PMID

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Abstract

INTRODUCTION: A corrosive injury to the upper gastrointestinal tract is a common problem and has a wide spectrum of presentations. We have prospectively evaluated 16 patients who ingested corrosive substances for the location, extent and the severity of injury and its outcome. The best time to assess the injury is by 12-48 hours of ingestion of the corrosive substances. Upper gastrointestinal (GI) endoscopy is the single most important investigation which helps to grade the injury and to plan the further management.

MATERIALS AND METHODS: All the patients who presented to the Casualty and to the Out patients Department of the H S K hospital, Bagalkot, during August 2009 to July 2010, with a history of corrosive agent ingestion were admitted and resuscitated. In the indicated cases, upper GI endoscopy was done to assess the severity of the injury. The following grading system was used. Grade 0- Normal mucosa, Grade1(superficial)- Superficial hyperaemia and oedema, Grade2A (Transmucosal)- Haemorrhage, exudates, linear erosions, blisters, shallow ulcers involving the mucosa and the submucosa, Grade2B- Circumferential burn present, Grade3-Deep ulceration, eschar formation with necrosis, full thickness injury with and without perforation.

RESULTS: Out of the 16 patients, 10 were females and most were of the age group of 10-30 years.10 had consumed acid and 3 alkalis and in another 3 cases, the substance which was ingested was not elicitable. 15 patients had consumed the substances with suicidal intentions and in only one patient it was accidental. The predominant symptom was pain and most had oesophageal injuries. The grade 2 injury was the most common type of injury. 13 patients were managed conservatively and 3 required surgery. The most common complication was a stricture in the oesophagus.

CONCLUSION: The corrosive injury is more common in females. Most of the patients were of younger ages. Acid ingestion was more common than alkali ingestion, and most had suicidal intentions. Early upper G.I. endoscopy has a definite role in diagnosing the severity of the injury and in planning the management. Most of the patients with corrosive injuries can be managed conservatively with follow up for the stricture, which is the most common complication that is often treated by dilatation.

Language: en

Keywords

adolescent; adult; human; burn; child; female; male; accident; resuscitation; sex difference; suicide attempt; disease severity; article; controlled study; disease classification; symptomatology; school child; clinical article; controlled clinical trial; age distribution; bleeding; necrosis; ingestion; edema; alkali; esophagus stricture; gastrointestinal disease; erosion; thorax disease; conservative treatment; gastrojejunostomy; gastroscopy; esophagus injury; acid; intestine perforation; carcinoma; Endoscopy; Acid; ulcer; blister; hyperemia; hiatus hernia; gastrointestinal pain; stomach antrum resection; aortoesophageal fistula; Alkali; antral stricture; Corrosive substances; exudate; stomach obstruction; submucosa; thickness; upper gastrointestinal tract burn