Endoscopy 2018; 50(04): S157
DOI: 10.1055/s-0038-1637508
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC FINDINGS AND OUTCOME IN CAUSTIC INGESTION OF ACID AND ALKALINE AGENTS IN ADULTS

M Hollenbach
1   University of Leipzig, Department of Internal Medicine, Neurology and Dermatology; Division of Gastroenterology and Rheumatology, Leipzig, Germany
,
J Tünnemann
1   University of Leipzig, Department of Internal Medicine, Neurology and Dermatology; Division of Gastroenterology and Rheumatology, Leipzig, Germany
,
MF Struck
2   University of Leipzig, Department of Anaesthesiology and Intensive Care Medicine, Leipzig, Germany
,
J Feisthammel
1   University of Leipzig, Department of Internal Medicine, Neurology and Dermatology; Division of Gastroenterology and Rheumatology, Leipzig, Germany
,
T Schlosser
1   University of Leipzig, Department of Internal Medicine, Neurology and Dermatology; Division of Gastroenterology and Rheumatology, Leipzig, Germany
,
T Schaumburg
1   University of Leipzig, Department of Internal Medicine, Neurology and Dermatology; Division of Gastroenterology and Rheumatology, Leipzig, Germany
,
J Mössner
1   University of Leipzig, Department of Internal Medicine, Neurology and Dermatology; Division of Gastroenterology and Rheumatology, Leipzig, Germany
,
A Hoffmeister
1   University of Leipzig, Department of Internal Medicine, Neurology and Dermatology; Division of Gastroenterology and Rheumatology, Leipzig, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Caustic ingestion in adults is a rare but potentially life-threatening problem. It remains controversial whether endoscopic findings and survival differ between acid and alkali ingestion. Thus, we compared ingestion of these agents and evaluated prediction parameters for survival and complications.

Methods:

Adults with caustic ingestion were analyzed from 2005 – 2016. Thirty-one patients were divided into acid (10) and alkali group (21). Mucosal injury was graded endoscopically by Zargar's score. Age, gender, intent of ingestion, caustic agents, comorbidities, management, complications and mortality were examined.

Results:

Ingestion of alkali resulted in higher grades (≥III) of esophageal (56% vs. 24%, p = 0.014) and stomach injuries (43% vs. 13%, p = 0.045) and was mostly done with suicidal intent (76% vs. 30%, p = 0.003). Age, gender, comorbidities, intensive care management, interventions, length of hospital stay and survival did not differ between the groups. Univariate but not multivariate logistic regression analysis revealed chronic renal failure and mediastinitis as risk factors for mortality. No independent risk factors for the development of esophageal stenosis were identified.

Conclusions:

Alkaline agents showed a higher grade of mucosal injury and are often used in suicidal intent. Mediastinitis and chronic renal failure are potential prediction parameters for survival but need to be evaluated in larger studies.