Korean J Gastroenterol.  2015 Jan;65(1):12-20. 10.4166/kjg.2015.65.1.12.

Caustic Injury of Upper Gastrointestinal Tract: 20 Year Experience at a Tertiary Referral Center

• Song HK
• Shim KN
• Yun HW
• Tae CH
• Kim SE
• Jung HK
• Jung SA
• Yoo K

• KMID: 2373175
• DOI: http://doi.org/10.4166/kjg.2015.65.1.12

Abstract

BACKGROUND/AIMS
Caustic ingestion can cause severe injury to upper gastrointestinal tract. There were few studies about clinical characteristics and treatments of caustic injury in Korea. We investigated the changes in clinical features of caustic injury over the past 20 years including pattern of endoscopic mucosal injury and treatment modality.
METHODS
This study was a retrospective review of medical records from patients with caustic injury from September 1993 through December 2012. Patients were classified into two groups based on the year when caustic ingestion occurred: patients who visited the hospital from 1993 to 2002 (early group) and patients who visited the hospital from 2003 to 2012 (late group).
RESULTS
A total 140 patients were included (early group [n=50] vs. late group [n=90]). Annual number of caustic ingestions did not show decreasing tendency over the past 20 years. Alkali ingestion increased (20.0% vs. 65.6%, p<0.001) and cases with more than grade 2b of esophageal mucosal injury decreased (41.3% vs. 20.7%, p=0.012) in late group. There were no differences between two groups in sex, age, proportion of accidental ingestion, and systemic/gastrointestinal complications. Use of gastric lavage (p<0.01) and broad spectrum antibiotics (p=0.03) decreased in late group. However, there was no difference in use of steroid between two groups.
CONCLUSIONS
In this study, overall caustic ingestion did not decrease and ingestion of alkali agents increased over the past 20 years. Tighter legislation on caustic agents is required and we need to be alert to the best management of caustic injury.

Keyword

Caustics; Gastrointestinal tract; Clinical features

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Caustics/*toxicity
Endoscopy, Digestive System
Esophageal Diseases/chemically induced/complications/*pathology
Esophageal Stenosis/complications
Female
Gastric Lavage
Humans
Logistic Models
Male
Middle Aged
Odds Ratio
Retrospective Studies
Severity of Illness Index
Tertiary Care Centers
Young Adult
Caustics

Figure

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  Fig. 1. Trend of caustic ingestion. Annual number of caustic ingestions didn't decrease and alkali ingestion significantly increased over the past 20 years (Linear-by-linear association; Acid, p=0.312; Alkali, p=0.017; Total N, p=0.213).

Reference

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