Abstract :
The aim of this paper was to present the im¬portance of esophagogastroduodenoscopy in the rapid diagnosis and adequate treat¬ment, 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 poi¬sonings and injuries of the upper part of gas¬trointestinal 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 inju¬ries at admission and discharge, for Z=5.3 and p<0.001 showed a significant differ¬ence. It showed greater number of patients with normal findings during the endoscopic control, which is due to the used therapy. Beside od the gastric improvement, for Z=1.3 and p>0.05, diffence in the results (admission and discharge) didnʹt 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 deter¬mination of the grade and extent of post- corrosive 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.
