[Whether or not to perform an early endoscopy following ingestion of potentially caustic agents - a retrospective longterm analysis in a tertiary referral institution].
BACKGROUND
The optimal clinical management of patients following ingestion of potentially caustic lesions is still undetermined. In particular, the indication for early upper GI endoscopy in this context remains unclear.


OBJECTIVE
To draft recommendations regarding the use of early upper GI endoscopy following hospital admissions of patients after ingestion of potentially caustic agents.


METHODS
For this purpose, a retrospective cohort study of patients treated for ingestion of potentially caustic substances during a 13 year-period at the university hospital of Berne was performed.


RESULTS
In total, 61 patients with acute ingestion of potentially caustic substances were identified. Overall mortality was 5 %. 11/61 patients had to be admitted to the intensive care unit. Most ingestions were performed in suicidal intention (62 %). In 53 % of these patients, a combined ingestion of several substances occurred. In 33 % of patients, an early upper GI endoscopy was performed within 24 hours after ingestion. The degree of burn depended upon the hazard potential of the respective substance. In patients with ingestion of low risk substances, upper GI endoscopy was only performed when additional risk factors were present.


CONCLUSIONS
Based upon the results of the present study, ingestion of potentially caustic agents requires an individualized strategy whether or not to perform early endoscopy.
Universitätsklinik für Viszerale Chirurgie und Medizin, Bereich Gastroenterologie, Inselspital/Universitätsspital Bern, Switzerland.
J M
JM
Gschossmann
Universitätsklinik für Intensivmedizin, Inselspital/Universitätsspital Bern, Switzerland.
R
R
Schroeder
Universitätsklinik für Viszerale Chirurgie und Medizin, Bereich Gastroenterologie, Inselspital/Universitätsspital Bern, Switzerland.
F
F
Wyler
Universitätsklinik für Viszerale Chirurgie und Medizin, Bereich Gastroenterologie, Inselspital/Universitätsspital Bern, Switzerland.
U
U
Scheurer
Universitätsklinik für Allgemeine Innere Medizin, Inselspital/Universitätsspital Bern, Switzerland.
U
U
Schiemann
D002057:Burns, Chemical / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002424:Caustics / Q000506:poisoning*; D000066491:Clinical Decision-Making; D016145:Endoscopy, Digestive System / Q000401:mortality* / Q000706:statistics & numerical data*; D004940:Esophageal Stenosis / Q000139:chemically induced* / Q000401:mortality* / Q000473:pathology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D018579:Patient Selection; D011183:Postoperative Complications / Q000401:mortality / Q000473:pathology / Q000517:prevention & control; D015995:Prevalence; D011379:Prognosis; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D062606:Tertiary Care Centers; D016896:Treatment Outcome
D002424:Caustics