The Clinical Characteristics and Predisposing Factors for Complications of Caustic Injury of the Upper Digestive Tract: A Survey
DOI:
https://doi.org/10.61919/jhrr.v3i1.31Keywords:
Caustic Injuries, Upper Digestive Tract, Predisposing Factors, Complications, Clinical CharacteristicsAbstract
BACKGROUND: Caustic injuries of the upper digestive tract are severe conditions that result from the ingestion of corrosive substances. These injuries can lead to life-threatening complications and often require extensive medical intervention. The clinical presentation and prognosis of these injuries depend on numerous factors, including the type, concentration, and volume of the ingested substance, the duration of contact with mucosal surfaces, and individual predisposing factors.
OBJECTIVE: The aim of this study was to assess the clinical characteristics and predisposing factors for complications of caustic injuries of the upper digestive tract in a clinical setting.
METHODS: This was a cross-sectional survey involving 170 patients at Rawalpindi Medical College, Rawalpindi. The study used a questionnaire that focused on demographic data, clinical presentation, ingestion details, pre-existing medical conditions, severity of injury, and complications. The data were statistically analysed to establish correlations and draw insights.
RESULTS: The majority of the participants were males (59%), with an average age of 45 years. The most common symptoms at presentation were oral pain (82%), dysphagia (71%), and drooling (59%). Household cleaners were the most commonly ingested substance (53%). Pre-existing conditions such as GERD (18%) and hiatal hernia (12%) were present in a significant number of patients. According to the Zargar classification, 47% of injuries were mild (Class I), 29% moderate (Class II), and 24% severe (Class III). Complications were reported in 35% of the patients, with strictures being the most common complication (58% of the complications).
CONCLUSION: This study highlights the impact of demographic and clinical factors, ingestion details, and pre-existing medical conditions on the severity of caustic injuries and the development of complications. These findings underscore the need for public education on the dangers of corrosive substances, early clinical intervention, and comprehensive management plans.
Downloads
References
Gill M, Tee D, Chinnaratha MA. Caustic ingestion: has the role of the gastroenterologist burnt out? Emergency Medicine Australasia. 2019;31(3):479-82.
Patel D. Caustic injuries of the Esophagus. The Esophagus. 2021:757-68.
Broderick RC, Ravi K. Management of Caustic Injury and Esophageal Stricture. The AFS Textbook of Foregut Disease: Springer; 2023. p. 375-84.
Mu H-W, Chen C-H, Yang K-W, Pan C-S, Lin C-L, Hung D-Z. The prevalence of esophageal cancer after caustic and pesticide ingestion: A nationwide cohort study. PloS one. 2020;15(12):e0243922.
Hollenbach M, Tünnemann J, Struck MF, Feisthammel J, Schlosser T, Schaumburg T, et al. Endoscopic findings and outcome in caustic ingestion of acidic and alkaline agents in adults: A retrospective analysis. Medicine. 2019;98(35).
Patterson KN, Beyene TJ, Gil LA, Minneci PC, Deans KJ, Halaweish I. Procedural and surgical interventions for Esophageal stricture secondary to caustic ingestion in children. Journal of Pediatric Surgery. 2023.
Adepoju AA, Asinobi AO, Ademola AD, Akinyinka OO, Abioye O, Adelaja A, et al. Zinc phosphide (rodenticide) poisoning: a case report of deliberate self-harm in an eleven-year-old. Nigerian journal of paediatrics. 2022;49(1):90–4-–4.
Hall AH, Jacquemin D, Henny D, Mathieu L, Josset P, Meyer B. Corrosive substances ingestion: a review. Critical reviews in toxicology. 2019;49(8):637-69.
Agarwal A, Srivastava DN, Madhusudhan KS. Corrosive injury of the upper gastrointestinal tract: the evolving role of a radiologist. The British Journal of Radiology. 2020;93(1114):20200528.
Alser O, Hamouri S, Novotny NM. Esophageal caustic injuries in pediatrics: a sobering global health issue. Asian cardiovascular and thoracic annals. 2019;27(6):431-5.
Sarma MS, Tripathi PR, Arora S. Corrosive upper gastrointestinal strictures in children: difficulties and dilemmas. World Journal of Clinical Pediatrics. 2021;10(6):124.
Fernandes DC, Norman AJ. Drug-induced gastrointestinal disorders. Medicine. 2019;47(5):301-8.
Chen Y-J, Seak C-J, Kang S-C, Chen T-H, Chen C-C, Ng C-J, et al. A new perspective of the risk of caustic substance ingestion: the outcomes of 468 patients in one North Taiwan medical center within 20 years. Clinical toxicology. 2021;59(5):409-17.
Sethia R, Gibbs H, Jacobs IN, Reilly JS, Rhoades K, Jatana KR. Current management of button battery injuries. Laryngoscope Investigative Otolaryngology. 2021;6(3):549-63.
Muhieldin MA, Larson C, DeCaen A, Alrajhi Y, EL‐Andari R, Perry T, et al. Surgical repair of massive hemorrhage secondary to button battery ingestion causing aortoesophageal fistula. Journal of Cardiac Surgery. 2022;37(7):2112-4.
Xu G, Chen Y-c, Chen J, Jia D-s, Wu Z-b, Li L. Management of oesophageal foreign bodies in children: a 10-year retrospective analysis from a tertiary care center. BMC Emergency Medicine. 2022;22(1):1-9.
Funk EM, Hooge NB, Pitman JS. Button Battery Ingestion in Children: A Dangerous Foreign Body. The Journal for Nurse Practitioners. 2023;19(5):104601.
D’Souza SM, Vallabhaneni M, Houston KV, Cundra L, Vilela A, Yoo BS, et al. Esophageal dysbiosis and pathogenesis of gastroesophageal reflux disease. Esophageal Disease and the Role of the Microbiome: Elsevier; 2023. p. 47-60.
Cohen D, Bermont A, Richter V, Shirin H. Real world management of esophageal ulcers: analysis of their presentation, etiology, and outcomes. virus (HIV). 2021;1:2.
Katzka DA, Kahrilas PJ. Advances in the diagnosis and management of gastroesophageal reflux disease. bmj. 2020;371.
Flores L, Krause C, Pokala B, Hosein S, Armijo PR, Mishra T, et al. Novel therapies for gastroesophageal reflux disease. Current Problems in Surgery. 2019;56(12):100692.
Mahmoudvand Z, Shanbehzadeh M, Shafiee M, Kazemi-Arpanahi H. Developing the minimum data set of the corrosive ingestion registry system in Iran. BMC health services research. 2022;22(1):1-13.
Shah J, Bush N, Rajan K, Nain C, Singh K, Kochhar R. Gastric secretion in patients with caustic ingestion: A prospective study. Indian Journal of Gastroenterology. 2021;40:50-5.
Ngobese A, Govender S, Peer N, Sheik-Gafoor MH. Caustic ingestion in children treated at a tertiary centre in South Africa: can upper endoscopy be omitted in asymptomatic patients? Pediatric surgery international. 2022:1-8.
Valencia C, Prieto J, Jara J, Pesantez P, Jara Sr J. Esophagogastric Complications After Caustic Ingestion: A Case Report. Cureus. 2022;14(7).
Rabeh RB, Mazigh S, Yahyaoui S, Boukthir S. Caustic ingestion in Tunisian children: Endoscopic findings, complications and predictors of severe injuries in a cohort of 1059 patients. Archives de Pediatrie. 2022;29(8):573-80.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 superadmin_jhrlmc superadmin_jhrlmc; Dr Abdullah Arshad, Dr Gohar Kaleem
This work is licensed under a Creative Commons Attribution 4.0 International License.
