Is esophagogastroduodenoscopy (EGD) indicated in evaluation of all cases of caustic ingestion?

S. K. Gupta, S. K.F. Chong, J. M. Croffie, J. F. Fitzgerald

Research output: Contribution to journalArticle

Abstract

Introduction: It is unclear if symptoms (sx) alone can identify patients (pts) with caustic ingestion who will benefit from EGD. The published studies are contradictory; one study (1) stated that sx cannot predict the presence/severity of esophageal damage, another (2) reported that presence of ≥2 sx better predicts esophageal injury opposed to just one sx. Aim: To determine relationship between sx and EGD findings in pts with caustic ingestion. Methods: Chart review of all caustic ingestions over last 4 years (12/93-11/97). Results: 22 pts (11 females; mean age 2.14 yrs [range 1-4.92 yrs]) underwent EGD after caustic ingestion. 4/22 (18%) pts were asymptomatic and had normal EGD. 10/22 (45%) pts had normal EGD though all were symptomatic (only 1 pt had >1 sx [vomiting + stridor]). 8/22 (36%) pts had esophageal injury on EGD and all were symptomatic. Esophageal injury was graded as 1 (mucosal erythema), 2 (superficial burns) or 3 (deep burns). The injury was grade 1 in 4/8 pts and grade 2 in 1/8 pts; only 1 pt had >1 sx (vomiting + drooling). 3/8 pts had grade 3 injury of whom 2 pts had 2 sx (vomiting + drooling, drooling + stridor) and 1 pt had 1 sx (dysphagia). Summary: Our data, to some extent, supports the latter study but we had 1 pt with grade 3 injury who had just 1 sx. We, however, had no pts who were asymptomatic and had esophageal injury of any grade. Thus, while all pts with clinically significant esophageal injury (i.e., grade 2 or 3) were symptomatic, no single or group of sx could identify all pts with potentially serious esophageal injury.

Original languageEnglish (US)
Pages (from-to)AB63
JournalGastrointestinal endoscopy
Volume47
Issue number4
StatePublished - Dec 1 1998

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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