title: [Caustic injury of upper gastrointestinal tract: 20 year experience at a tertiary referral center].
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Health Promotion Medicine, Ewha Womans University Medical Center Mokdong Hospital, Seoul, Korea.
authors.forename: Hye Kyung
authors.initials: HK
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Ki Nam
authors.initials: KN
authors.lastname: Shim
authors.affiliation: Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Yun
authors.affiliation: Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Chung Hyun
authors.initials: CH
authors.lastname: Tae
authors.affiliation: Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Seong Eun
authors.initials: SE
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Hye Kyung
authors.initials: HK
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Sung Ae
authors.initials: SA
authors.lastname: Jung
authors.affiliation: Department of Health Promotion Medicine, Ewha Womans University Medical Center Mokdong Hospital, Seoul, Korea.
authors.forename: Kwon
authors.initials: K
authors.lastname: Yoo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002424:Caustics / Q000633:toxicity*; D016145:Endoscopy, Digestive System; D004935:Esophageal Diseases / Q000139:chemically induced / Q000150:complications / Q000473:pathology*; D004940:Esophageal Stenosis / Q000150:complications; D005260:Female; D005751:Gastric Lavage; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012720:Severity of Illness Index; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D002424:Caustics