Citation

Bouabdellah S, Hannache K, Roula D, Benmati A, Bouhroum A, Kellil M. Acta Endoscopica 2011; 41(4): 200-205.

Copyright

(Copyright © 2011)

DOI

10.1007/s10190-011-0178-4

PMID

unavailable

Abstract

OBJECTIVES: The severity of caustic ingestion is difficult to predict. The aim of this study was to establish a correlation between the characteristics of ingestion, clinical symptoms and endoscopic lesions which result from caustic ingestion.

PATIENTS AND METHODS: In this monocentric prospective study, all adult patients treated between 2006 and 2008 for a caustic ingestion whose details were known were included. We proceeded to statistical correlations between the characteristics of ingestion and different clinical symptoms which result from this and the results of endoscopy.

RESULTS: Three hundred fourteen cases of caustic ingestion were collected, with a mean age of 28.12 years (15-79 years).A suicidal ingestion was associated with a significantly greater quantity of corrosive substance (P = 0.01). The type of caustic introduced was a risk factor for dysphagia (48.8%; P = 0.02), haematemesis (61.2%; P < 0.0001), peritonitis (78.3%; P = 0.002), laryngeal oedema (P = 0.002) and several endoscopic lesions (grade IV). The dysphagia (73.7%; P = 0.0048), the haematemesis (85.2%; P < 0.0001), the respiratory distress (91.7%; P = 0.001) or the oro-pharyngeal injuries (72.8%; P = 0.0002) were predictors of severe endoscopic lesions. However, a third of the patients without symptoms had severe lesions during endoscopic examination.

CONCLUSION: In caustic ingestion, the acid nature of the substance and the presence of dysphagia, haematemesis or oral burns are factors predicting severe endoscopic lesions and must encourage an urgent care of patients in resuscitation. The existence of severe endoscopic lesions in a third of the patients without symptoms imposes the systematic realization of endoscopy in all patients. © 2011 Springer Paris.

Language: fr

Keywords

adolescent; adult; human; suicide; aged; resuscitation; clinical trial; disease severity; prediction; risk factor; article; major clinical study; disease association; caustic burn; dysphagia; caustic agent; larynx edema; respiratory distress; acidity; gastrointestinal endoscopy; peritonitis; quantitative analysis; chemical injury; Endoscopy; Ingestion; hematemesis; Corrosive substances; digestive corrosive injury; mouth burn; oropharynx injury