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Clinical Manifestation and Factors Related to the Severity of Corrosive Ingestion Patients: The Single Center’s Experience

Pawan Chansaenroj MD*, Piyawat Wongvanich MD*

Affiliation : * Department of Surgery, Somdech Phra Pinklao Hospital, Bangkok, Thailand

Background : Corrosive ingestion is one of the common and serious problems in Thailand. The present study aimed to describe the clinical manifestation of corrosive ingestion patient and identify factors related to the severity of an esophageal injury.
Objective : To review the clinical manifestation of the patients presented with corrosive ingestion at the Somdech Phra Pinklao Hospital and to analyze the correlation between the clinical manifestation and the correlation of the severity of the esophageal injury. Material and Method: We reviewed the medical records of patients presented with corrosive ingestion at the emergency department of the Somdech Phra Pinklao Hospital between January 2004 and June 2012, and analyzed their correlation between these data and the severity of an esophageal injury.
Results : There were 131 patients (82 women, 49 men) with mean age of 27 years. The most common reason of corrosive ingestion was argumentation with their partner. Acid was a more common corrosive substance than base (acid = 118 and base = 13). The clinical manifestation was nausea/vomiting, dysphagia, chest pain, abdominal pain, hoarseness, drooling, and hematemesis. Esophagogastroduodenoscopy was performed in 117 patients. The results showed esophageal injury grade 1 in 41 patients, grade 2a in 31 patients, grade 2b in 11 patients, grade 3a in 11 patients, and grade 3b in one patient. Three cases developed esophageal perforation. After two months follow-up, there were esophageal strictures in 30% of grade 2b and 100% of grade 3a.
Conclusion : Corrosive ingestion is more common in female and from acid agent. Leukocytosis, chest pain, and vomiting are associated with severity of esophageal injury. Severity according to initial esophagogastroduodenoscopy could predict subsequence stricture.

Keywords : Corrosive ingestion, Caustic injury, Esophageal injury


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JMed Assoc Thai
MEDICAL ASSOCIATION OF THAILAND
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