Clinical Features of Corrosive Ingestion
CHITTINAD HA V ANOND, MD*
Affiliation : * Department of surgery, Faculty of Medicine Thammasart University, Path urn Thani 12120, Thailand.
Objective :To study the clinical presentation after corrosive ingestion.
Setting : A University Hospital.
Design : Prospective descriptive study.
Patients and
Method : Corrosive ingestion patients were studied, from July 2000 to December 2002. Reasons for ingestion, symptoms, physical findings and routine investigations were recorded in a standard form. Data analysed using the descriptive statistical method.
Results : There were 73 patients, 55 women and I8 men, median age 22 years, 48 (65.8%) of whom had ingested strong acid, 3 (4.1 %) ingested strong alkali. Suicidal gesture was the most com mon reason for ingestion (89.2% ). The amount of ingestion was less in accidental cases. Symptoms of nausea/vomiting, drooling and abdominal tenderness were associated with the amount of ingestion, while severity of lips, buccal mucosa and palate injuries was significantly related with strong corrosive agents (p < 0.05). Leucocytosis was found in patients who had symptoms of drooling, hoarseness, stridor and signs of mucosal slough or superficial ulcers (p < 0.05). Four required surgery. Two of them had esophago-gastrectomy. Twenty-one patients were followed-up, with the median follow-up time of II (1-28) months. One patient died from HIV infection. The rest were normal.
Conclusion : Drooling and oral mucosal slough or ulcers were significant findings and were related to the amount and strength of the corrosive substance ingested, respectively. To meet the goal of a holistic approach, attention must also be given to psychiatric management, and surgeons should provide a supportive role.
Keywords : Corrosive Ingestion, Corrosive Injury, Clinical Presentation, Suicide, Adjustment Disorder, Epidemiology
