A Study of Clinical and Endoscopic Profile of Acute Corrosive injury of the UGI tract in Adult population – a single centre study

Dr Ravi Anand; Dr K. Caroline Selvi; Dr A.Anand

Volume : VIII, Issue : IV, April - 2019

A Study of Clinical and Endoscopic Profile of Acute Corrosive injury of the UGI tract in Adult population – a single centre study

Dr Ravi Anand, Dr K. Caroline Selvi, Dr A. Anand

Abstract :

INTRODUCTION –Corrosive injuries are one of the important public health issues especially in developing countries like India causing a spectrum of complications. AIM–To reviewclinical and endoscopic findings of patients with acute corrosive injuryand management of these patients.METHODS–In this prospectivestudy,clinical data of 61 patients were collectedfrom July 2016 to July 2017 who came at our centre with corrosive ingestion within 48 hrs.Full clinical examination was done and chest x ray was taken.Patients with no evidence of perforation underwent upper GI endoscopyand initial conservative management was instituted.Corrosive injuries were graded by Zargar�s classification.RESULTS–Out of 61 patients,completeevaluation was possible only in 53 patients.37 male and 16 female patients were evaluated and mean age was 29 years.Mean time interval of presentation was 17 hours and volume of corrosive ingestion was 20 to 150ml.Most common corrosive in our study were acids that included hydrochloric acid(n=28),phenyl(n=9),sulphuric acid (n=2),nitric acid(n=2),aqua regia (n=1)alongwith alkali(n=9)and 2 cases of kerosene ingestion.5cases were accidental while 48 cases were of suicidal ingestion.Most common clinical feature in our study wereoropharyngeal injuries(n=43),epigastric pain(n=34),sialorrohea(n=31),vomiting(n=30),odynophagia(n=25)and dysphagia(n=23).46 patients had esophageal injuries(grade I= 27,IIa = 9, IIb = 5, III=5 ) while 40 patients had gastric injuries(grade I = 18, IIa = 9, IIb = 5, III =8).Ryle�s tube(RT) insertion were done in 6 patients with gradeIIb and IIIinjuries.Patientswho came for review after 4 to 8 weeks improved spontaneously with grade I and IIa injuries.5 patients with IIb and III injuries required feeding jejunostomy initially while all 6 patients with RT required dilatation after 4 weeks.CONCLUSION –Patients with acute corrosive injury can be assessedreliably and accuratelybyupper GI endoscopy and proper clinical examination and managed accordingly