Yetişkinlerde Koroziv Madde Alımı: Endoskopik Bulguların ve Komplikasyonların Yedi Yıllık Retrospektif Analizi

Abstract

Amaç: Doku hasarına neden olma potansiyeli olan maddelerin yutulması eylemi olarak tanımlanan koroziv madde alımı, önemli bir tıbbi acil durumdur. Erken dönemde değerlendirilmezse yüksek morbidite ve mortaliteye yol açabilir ve uygun şekilde yönetilmediğinde uzun dönem komplikasyonlara neden olabilir.

Gereç ve Yöntemler: Bu retrospektif çalışma, Nisan 2016 ile Temmuz 2023 tarihleri arasında Acil Servis’e koroziv madde alımı şikayetiyle başvuran ve endoskopi yapılması amaçlı Gastroenteroloji bölümüne yönlendirilen yetişkin hastaları içermektedir. Hastaların yaş, cinsiyet gibi demografik özellikleri; koroziv madde alım amacı, yutulan koroziv maddenin türü, endoskopik bulgular ve komplikasyonları tıbbi kayıtlar üzerinden değerlendirildi.

Bulgular: Koroziv madde alımı nedeniyle gastroenterolojiye danışılan 143 hasta saptandı. En sık yutulan koroziv madde %51,1 (n=67) oranıyla çamaşır suyu, ikinci sırada ise %20,6 (n=27) oranıyla kireç çözücüydü. Hastaların 97’si (%74) intihar amacıyla, 34’ü (%26) ise kazara koroziv madde almıştı. Endoskopik değerlendirmede 49 hastada (%37,4) patolojik bulgu saptanmazken, 16 hastada (%12,2) orta-şiddetli hasar (Zargar Evre 2B–3B) görüldü. Uzun dönem komplikasyon olarak 2 hastada özofagus darlığı, 4 hastada ise mide çıkış obstrüksiyonu gelişti.

Sonuç: Koroziv madde alımı, ciddi bir tıbbi ve halk sağlığı sorunu olmaya devam etmektedir. Zargar sınıflaması, komplikasyonların gelişimi için en önemli bağımsız prediktördür. Erken endoskopik değerlendirme, doku hasarının tanımlanması, tedavinin belirlenmesi ve prognozun öngörülmesinde en etkin yöntemdir.

Keywords

• Koroziv hasar
• endoskopi
• Zargar skoru

Ethical Statement

Bu çalışma, Bakırçay Üniversitesi Etik Kurulu tarafından onaylanmıştır (karar no: 1110 / 26.7.2023).

Corrosive Substance Ingestion in Adults: Seven-Year Retrospective Analysis of Endoscopic Findings and Complications

Abstract

Aim: Corrosive ingestion which is the act of swallowing substances that have the potential of causing tissue damage, presents a significant medical emergency. If not evaluated early, can lead to high morbidity and mortality as well as long-term complications if not managed appropriately

Material and Methods: This retrospective study included adult patients who were admitted to the Department of Emergency Medicine and referred to Gastroenterology with the complaint of caustic ingestion and underwent upper gastrointestinal endoscopy between April 2016 and July 2023. We evaluated the demographic findings of the patients, such as age, gender; intent of ingestion, characteristic of the caustic materials ingested, endoscopic findings and complications from medical records.

Results: We identified 143 patients who were consulted to gastroenterology due to caustic ingestion. The mostly ingested caustic materials were household bleach as 51.1% (n:67) and limescale remover as 20.6% (n:27). 97 patients had suicidal intent (74%) and 34 patients ingested caustic agent incidentally (%26).  49 patients (37.4%) had no pathological findings in their endoscopic evaluation, whereas 16 patients (12.2%) presented moderate to severe injuries (Zargar Grade 2B–3B). Long-term complications were esophageal stricture in 2 patients and gastric outlet obstruction in 4 patients.

Conclusion: Corrosive substance ingestion remains a serious medical and public health concern. Zargar’s classification is the most important independent predictor in development of complications. Early endoscopic evaluation is the most effective method for identifying tissue injury, determining treatment, and predicting prognosis.

Keywords

• Corrosive injury
• endoscopy
• Zargar score

Ethical Statement

The study was approved by the Ethical Committee of Bakircay University (decision no: 1110 / 26.7.2023).

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