Abstract
IntroductionPotentially catastrophic presentations and lifelong complications resulting from corrosive ingestions in humans is one of the most challenging situations encountered in clinical medical practice. This study reviewed pattern, mechanisms and associated socio-medical challenges with ingestion of corrosive agents as seen in a tertiary health institution in South-western Nigeria.MethodsA retrospective review of all patients that were managed for corrosive ingestion at Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Osun State, Nigeria, over a seven year period.ResultsA total of 28 patients M:F: 1.6:1. There were 7 children and 21 adults. Majority (78.6%) of the patients ingested alkaline substances. Accidental ingestion occurred in 28.6% while 71.4% resulted from deliberate self harm especially among adults (66.7%). Almost two thirds (64.3%) of the patients presented after 48hrs of ingestion. Patients who presented early were managed conservatively. Most patients (64.3%) who presented late had nutritional and fluid rehabilitation. Two patients died from oesophageal perforation and resulting septicaemia. Psychiatric evaluation revealed that seven adults (25%) had psychotic illness while (42.9%) of the patients developed oesophageal strictures. Short segment strictures were managed with oesophageal dilatation with good outcome while long and multiple segment strictures were referred to cardiothoracic surgeons for management.ConclusionCorrosive oesophageal injuries remain a prevalent and preventable condition in the developing countries. Preventive strategies should include regulation and packaging of corrosive substances, organization of psychiatric services, and education of the population on corrosive ingestion.
Highlights
Catastrophic presentations and lifelong complications resulting from caustic ingestions in humans is one of the most challenging situations encountered in clinical medical practice [1,2,3]
The ingestion leads to destruction of tissue which can result in complications such as respiratory distress, oesophageal and gastric perforations, septicaemia and death [2]
Accidental ingestion occurred in 8 (28.6%) patients while in 20 (71.4%) patients ingested for deliberate self harm
Summary
Catastrophic presentations and lifelong complications resulting from corrosive ingestions in humans is one of the most challenging situations encountered in clinical medical practice. Catastrophic presentations and lifelong complications resulting from caustic ingestions in humans is one of the most challenging situations encountered in clinical medical practice [1,2,3]. Corrosives are usually ingested either for suicidal or for medicinal purposes [2,7] In this population, the injuries are often more serious because they are intentional [3]. The degree and extent of corrosive lesion and its complications depend on several factors such as concentration of caustic substance, quantity swallowed, fullness of the stomach and duration of contact with tissue or organs [6,10] and the quality of care given at the initial management of the patient at presentation. The common causes of benign oesophageal stricture are hiatal hernia and reflux esophagitis but in Nigeria, the most common cause of benign oesophageal stricture is ingestion of corrosive [7]
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