Factors Associated with Severe Mucosal Injury of Esophagogastroduodenoscopy after Caustic Substance Ingestion in Pediatrics

Ma. Charina Batac-Dizon,1 Cynthia P. Cordero2 and Germana V. Gregorio1

1Section of Pediatric Gastroenterology, Hepatology and Nutrition.
Department of Pediatrics, College of Medicine and
Philippine General Hospital, University of the Philippines Manila
2Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila

Objective. To determine the prevalence of and factors associated with severe mucosal injury on signs/symptoms (oral lesions, drooling, vomiting, abdominal pain, dysphagia).

Results. 320 patients were investigated: 155 (48%) accidental and 165 (52%) intentional cases. In accidental intake, majority (84%) were <=6 years old [mean(SD) age: 3.7 (4.3) yrs, 59% males]. 10% had severe mucosal injury. The odds of severe injury increased in the presence of >=2 signs/symptoms: OR=7.0 for 2 and OR=62.2 for >2. In intential cases, the mean (SD) ae was 16 (1.6) years, 74% females. Severe mucosal injury was seen in 5% and associated with acidic agent (OR=54.8).

Conclusions. Severe mucosal injury on EGD occurred in 10% and 5% among accidental and intentional cases, respectively. In accidental cases, probability of severe injury increased in the presence of >=2 signs/symptoms. In intentional cases, acid intake was the only factor associated with severe injury. In the local setting, presence of these factors among patients with caustic ingestion will help identify high-risk patients who need EGD-guided management.

Key Words: acid, alkali, mucosal injury, Zargar, caustic injestion