Clinical impact of upper gastrointestinal tract injuries in glyphosate-surfactant oral intoxication.
Fifty patients with glyphosate-surfactant oral ingestion were studied with upper gastrointestinal (UGI) endoscopic grading using Zargar's modified grading system for mucosal corrosive injury. Esophageal injury was seen in 68% of the patients, gastric injury in 72%, and duodenal injury in 16%. There were no grade 3 injuries. The upper gastrointestinal tract injuries caused by glyphosate-surfactant were minor in comparison with those by other strong acids. The WBC count, amount of glyphosate-surfactant ingested, length of hospital stay and the occurrence of serious complications increased markedly in the group which had grade 2 esophageal injuries. Thus, the severity of the esophageal injuries may be a prognostic factor for the patient with glyphosate-surfactant ingestion. The UGI endoscopy may be indicated for grading esophageal injury in patients who have ingested glyphosate-surfactant in amounts greater than 100 ml. Physicians should pay more attention to the patients with grade 2 or 3 esophageal injuries to prevent serious complications and to provide aggressive supportive care.
Chang
C Y
CY
Department of Emergency Medicine, Taichung Veterans General Hospital, Taiwan, Republic of China.
Peng
Y C
YC
Hung
D Z
DZ
Hu
W H
WH
Yang
D Y
DY
Lin
T J
TJ
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004386:Duodenum / Q000187:drug effects / Q000473:pathology; D004935:Esophageal Diseases / Q000139:chemically induced* / Q000473:pathology; D004945:Esophagoscopy; D004947:Esophagus / Q000187:drug effects* / Q000473:pathology; D005260:Female; D005998:Glycine / Q000031:analogs & derivatives* / Q000506:poisoning; D006540:Herbicides / Q000506:poisoning*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000187:drug effects / Q000473:pathology; D013270:Stomach / Q000187:drug effects / Q000473:pathology; D000097797:Glyphosate
D005998:Glycine; D006540:Herbicides; D000097797:Glyphosate