Is esophagoscopy necessary for corrosive ingestion in adults?
The aim of the study was to determine whether early esophagoscopy is really necessary for the patients who have ingested a corrosive agent. Patients who were followed up with the diagnosis of corrosive ingestion in our clinic between the years 1998 and 2008 were studied retrospectively. The data were collected through the medical records of the patients and from interviews with them. The analyzed parameters included age, gender, the nature and the amount of the ingested agent, whether the event was accidental or suicidal, diagnostic tools, treatment and the results of the treatment, and long-term follow up. Over a 10-year period, a total of 124 cases of corrosive ingestion cases were determined. Of these, 64 (51.6%) were male and 60 (48.4%) were female. The mean age was 38 +/- 17.5 years. The most commonly ingested corrosive agents were sodium hypochlorite in 50 (40.3%) patients and hydrochloric acid in 33 (26.6%) patients. The mean admission time for the emergency department after ingestion of the corrosive agent was 2.5 +/- 3.7 hours. Ingestion was accidental in 82% of the patients and as a result of a suicide attempt in 18%. The amount of ingested corrosive agent in the suicidal group (190 +/- 208.3 mL) was higher than that of accidental group (66 +/- 58.3 mL) (P= 0.012). Nine patients underwent esophagoscopy, six of which were performed in other clinical centers. Only three (2.4%) patients experienced esophageal stricture, which were treated with repeated dilatations. In the long-term follow up, we could get in touch with only 63 patients and none of them had complications due to corrosive ingestion. The follow-up period ranged from 1 to 120 months (median 45 +/- 29.2 months). Based on our study, early esophagoscopy appears to be unnecessary in adult patients who ingested the corrosive agent accidentally. A larger prospective study is needed to answer the question.
Celik
Burcin
B
19 Mayis University Medical School, Department of Thoracic Surgery, Samsun, Turkey. cburcin@hotmail.com
Nadir
Aydin
A
Sahin
Ekber
E
Kaptanoglu
Melih
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002057:Burns, Chemical / Q000628:therapy*; D002424:Caustics / Q000633:toxicity*; D004935:Esophageal Diseases / Q000139:chemically induced*; D004940:Esophageal Stenosis / Q000139:chemically induced / Q000628:therapy; D004945:Esophagoscopy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006851:Hydrochloric Acid / Q000633:toxicity; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012973:Sodium Hypochlorite / Q000633:toxicity; D019564:Unnecessary Procedures; D055815:Young Adult
D002424:Caustics; D012973:Sodium Hypochlorite; D006851:Hydrochloric Acid