The Role of Urgent Esophagogastroduodenoscopy in Prognosis of Acute Caustic Poisonings
Journal
Acta Informatica Medica
Date Issued
2011
Author(s)
Andon Chibishev
Vesna Chibisheva
DOI
10.5455/aim.2011.19.80-84
Abstract
Introduction: Ingestion of corrosive substances causes severe lesions to the upper gastrointestinal tract. The aim of this paper was to present our clinical experience with the 4-grade endoscopic classification of post-corrosive injuries in prognosis of the outcome in acute caustic poisonings.
Material and methods: This was a retrospective study comprising 33 patients with grade II B and III injury hospitalized at the University Clinic for Toxicology in Skopje,
Republic of Macedonia in the period 2008-2009. The grade of injury was determined
with urgent esophagogastroduodenoscopy performed in the first 12-24 hours. After
treatment the patients were followed for
a minimum of six months. Results: A total
of 33 patients were analyzed. At the time of
hospital admission post-corrosive injuries of
grade III predominated (n=22, 66.67%) and
post-corrosive injuries of grade II B (n=11,
33.33%). The most common late postcorrosive complications of the esophagus
was stenosis esophagei (n=19, 57.58%).
The most common post-corrosive damages
of the stomach were: stenosis antropylori
(n=10, 30.30%), stenosis pylori (n=6,
18.18%) and stenosis antri (n= 3, 9.09%).
Conclusion: Urgent esophagogastroduodenoscopy has to be done in all acute
caustic poisonings in the first 12-24 hours
and they are to be classified according to
Kikendall’s four-grade classification. The
classification in four grades of post-corrosive injuries to the upper gastrointestinal
tract might help in therapeutic approach
and prognosis of the outcome
Material and methods: This was a retrospective study comprising 33 patients with grade II B and III injury hospitalized at the University Clinic for Toxicology in Skopje,
Republic of Macedonia in the period 2008-2009. The grade of injury was determined
with urgent esophagogastroduodenoscopy performed in the first 12-24 hours. After
treatment the patients were followed for
a minimum of six months. Results: A total
of 33 patients were analyzed. At the time of
hospital admission post-corrosive injuries of
grade III predominated (n=22, 66.67%) and
post-corrosive injuries of grade II B (n=11,
33.33%). The most common late postcorrosive complications of the esophagus
was stenosis esophagei (n=19, 57.58%).
The most common post-corrosive damages
of the stomach were: stenosis antropylori
(n=10, 30.30%), stenosis pylori (n=6,
18.18%) and stenosis antri (n= 3, 9.09%).
Conclusion: Urgent esophagogastroduodenoscopy has to be done in all acute
caustic poisonings in the first 12-24 hours
and they are to be classified according to
Kikendall’s four-grade classification. The
classification in four grades of post-corrosive injuries to the upper gastrointestinal
tract might help in therapeutic approach
and prognosis of the outcome
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