[Clinical-epidemiological characteristics in caustics ingestion patients in the Hipólito Unanue National Hospital].
The ingestion of caustic substances represents a serious problem, often with devastating consequences on the esophagus and the stomach.


OBJECTIVE
1) Determine the main caustic substance ingested and the lesions on the esophageal-gastric mucose. 2) Find out the clinical-epidemiological characteristics of these patients in our hospital.


RESULTS
45 inpatients at the Hipólito Unanue National Hospital were evaluated between 1996 and 2001, 29 female patients (64.4%) and 16 male patients (35.6%) with an average age of 28 years in a range between 15 and 60 years. The caustic substances ingested were: bleach, 30 patients (66.7%), muriatic acid (hydrochloric acid) 13 patients (28.9%), nitric acid and caustic soda, one patient each (2.2%). Among the women: 24 patients ingested bleach (82.7%) 4 patients, muriatic acid (13.7%) and one patient, caustic soda (3.4%). Among the men: 9 patients took muriatic acid (56.3%) 6 patients, bleach (37.5%) 1 patient, nitric acid (6.25%); 29 patients ingested the caustic substances in pure form (64.4%) and 16 patients diluted with other substances: water, soft or alcoholic drinks, oatmeal (35.5%). The time passed between the ingestion and medical attention was of 104 minutes, with a range of 15 to 360 minutes. The average of total ingested solution was 73 ml., ranging between 10 ml and 170 ml. The reason for the ingestion was a conflict with their spouse, 24 patients (53.4%) family conflict, 13 patients (28.9%) accident, 4 patients (8.9%) psychiatric problems, 3 patients (6.7%) and a monetary factor, 1 patient (2.2%). The signs and symptoms when admitted into the hospital were: abdominal pain, 31 patients (68.9%) nausea, 22 patients (48.9%) vomit, 21 patients (46.7%) mouth cavity pain, 19 patients (42.2%) dysphagia, 14 patients (31.1%) sialorrhea, 14 patients (31.1%) odynophagia, 13 patients (15.6%) sensory disorder, 7 patients (15.6%) dysphonia, 3 patients (6.7%) and cephalea, 1 patient (2.2%). Oral compromise was: normal in 11 patients (24.4%) congestion in 23 patients (51.1%) and erosions in 11 patients (24.1%). Endoscopic lesions found were: grade 0 in 6 patients (13.3%) grade 1 in 21 patients (46.7%) Grade 2A in 7 patients (15.6%) Grade 3B in 2 patients (4.4%).


CONCLUSIONS
Adolescents and young adults are the age groups which most suffer of this pathology. Bleach is the most ingested caustic substance (66.7%). Women have a higher risk of ingesting a caustic substance (64.4%). Caustic substances are mostly ingested pure (64.4%). Conjugal conflicts are the main reason for caustic ingestion. Clinical symptoms vary, with abdominal pain being the main discomfort among these patients. Oropharyngeal congestion is the most frequent finding. Esophageal-gastric mucose edema and hyperemia (Zargar 1) are the endoscopic lesions mostly found.
Rodríguez
María Alba
MA
Servicio de Gastroenterología del Hospital Nacional Hipólito Unanue, Perú.
Meza Flores
José Luis
JL
D000293:Adolescent; D000328:Adult; D002057:Burns, Chemical / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D002424:Caustics / Q000009:adverse effects*; D004947:Esophagus / Q000293:injuries*; D005260:Female; D005753:Gastric Mucosa / Q000293:injuries*; D006783:Hospitals, State / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D012189:Retrospective Studies; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data
D002424:Caustics