A Clinical Study on the Upper Gastrointestinal Tract Injury Caused by Corrosive Agent / 대한소화기내시경학회지

ABSTRACT

BACKGROUND/AIMS: The incidence of corrosive injury has been decreased, compared with past years. However, the ingestion of corrosive agent for suicidal attempt is on an increasing trend. Though corrosive injury on gastrointestinal tract is very common, there are few clinical studies on this field. METHODS: Retrospective study was performed on 48 patients who ingested corrosive agent from 1992 to 1998. The kinds of corrosive agent, cause of ingestion, symptoms, gastroscopic findings, treatment and complications were analyzed. RESULTS: The most common agent of ingestion was acetic acid (47.9%), followed by hydrocholoric acid (18.8%), cresol (10.4%), lye (10.4%), sulfuric acid (4.2%). Ingestion for suicidal attempt (60.4%) was more frequent than accidental ingestion (39.6%). The frequent symptoms were sore throat (31.3%), dysphagia (27.1%), epigastric pain (22.9%), vomiting (18.8%), chest pain (18.8%), GI bleeding (12.5%), dyspnea (12.5%) and hematuria (8.3%). The esophagus was the most common site of corrosive injury and Grade IIa injury was the most frequent finding on gastroscopy. In most cases, prophylactic antibiotics with or without steroid was administered for conservative treatment. For long-term sequelae, there were 7 cases (14.6%) of esophageal stricture, and 2 cases (4.2%) of gastric outlet obstruction. CONCLUSIONS: Corrosive injury on gastrointestinal tract is frequently observed on early gastroscopy and can cause significant late sequelae, such as stricture. Therefore, it is necessary to evaluate regular follow up gastroscopy for the management of late sequelae.