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Acta Inform Med. 2010; 18(3): 131-135


Esophagogastroduodenoscopy and Endoscopic Classification in Diagnosis, Treatment andPrognosis of Patients with Acute Caustic Poisonings

Andon Chibishev.

Abstract
The aim of this paper was to present the importance of esophagogastroduodenoscopy in the rapid diagnosis and adequate treatment, outcome and prognosis of patients with caustic ingestion. Oral poisoning with caustic substances occurs by an ingestion of acids, alkalis, heavy metal salts, formalin, iodine tincture and many other chemical substances. Esophagogastroduodenoscopy is a sophisticated and sovereign method for diagnostic evaluation of acute corrosive poisonings and injuries of the upper part of gastrointestinal tract . According to the latest controlled studies the most optimal timing for esophagogastroduodenoscopy is the first 12 – 24 hours after the corrosive ingestion. Some authors suggest that upper endoscopy may be safely performed at least in the first 96 hours after the caustic ingestion. Our examined group consisted of 37 patients, 9 (24.3%) males and 28 (75.7%) females. The age of the patients ranged from 42.9 ± 16.5 years, ± confidence from 37.3 to 48.4 years; the youngest age category being 14 and the oldest 75 years. Poisoning with suicidal intent was registered in 35 (94.6%) and poisoning by accident in 2 (5.4%) patients. Analysis of the difference in the endoscopic control of the esophagus, related to its injuries at admission and discharge, for Z=5.3 and p0.05, diffence in the results (admission and discharge) didn’t show a significant difference. Caustic poisonings are an economic burden for the health care system because of the expensive treatment and moreover, post-corrosive injuries may cause a serious invalidity in these patients. Emergency endoscopy has proved to be a sovereign diagnostic procedure for determination of the grade and extent of postcorrosive lesions. The established changes correlate with the diagnostically confirmed severity of the poisoning, treatment and therapy as well as with eventual onset of late complications

Key words: caustic poisonings, esophagogastroduodenoscopy, esophageal caustic injuries



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