Ingestion of corrosive substances may cause severe to serious injuries of the upper gastrointestinal tract and the poisoning can even result in death. Acute corrosive intoxications pose a major problem in clinical toxicology since the most commonly affected population are the young with psychic disorders, suicidal intent and alcohol addiction. The golden standard for determination of the grade and extent of the lesion is esophagogastroduodenoscopy performed in the first 12-24 hours following corrosive ingestion. The most common late complications are esophageal stenosis, gastric stenosis of the antrum and pyloris, and rarely carcinoma of the upper gastrointestinal tract. Treatment of the acute corrosive intoxications include: neutralization of corrosive agents, antibiotics, anti-secretory therapy, nutritional support, collagen synthesis inhibitors, esophageal dilation and stent placement, and surgery.

B ackground: the ingestion of chemical agents, of caustic nature, represents a serious problem for clinical toxicology. If the ingestion doesn't cause death during the acute period, it will most often cause severe side effects in the upper gastrointestinal tract during the chronic phase. Aims: The purpose of this study is to show the clinical, epidemiological and socio-economical characteristics seen in acute corrosive poisonings such as ingested caustic agents, causes for abuse and most consequential complications. Material and methods: a ten year medical data was constructed and collected (2000-2009) from patients with acute corrosive poisonings who were hospitalized and treated in the University Clinic of toxicology and urgent internal medicine in Skopje, Republic of Macedonia. The variables included were: age, sex, type of poisonings and percentage of late post-corrosive complications. Results: In the study, 735 patients files were analyzed, collected in a period of ten years. The mean age of patients is 32.9±15.6 years. Majority of patients ingested hydrochloric acid (HCl; n=354; 48,16%). Conclusion: Demographic, diagnostic and therapeutic findings in acute corrosive poisonings are found to be similar to the findings observed in the referenced literature. Conclusively, women between 14 and 30 years old represent a high risk group; hydrochloric acid is the most often abused agent; and high percentage of post-corrosive complications are observed.

Acetic acid is a widely used organic acid with corrosive properties that depend on its concentration. If acetic acid is ingested in concentrations above 30 % it may severely damage the upper gastrointestinal tract and cause intravascular haemolysis, which can result in severe kidney and liver disorders and disseminated intravascular coagulation. In this retrospective study, we analysed acetic acid ingestion data collected at the University Clinic for Toxicology of Skopje, Macedonia from 1 January 2002 to 31 December 2011. The analysis included systemic complications, kidney damage, and the outcomes in particular. Over the ten years, 84 patients were reported at the Clinic to have ingested highly concentrated acetic acid. Twenty-eight developed kidney disorders, while the remaining 56 had no complications. Fatal outcome was reported for 11 patients, seven of whom had systemic complications and four severe gastrointestinal complications.

Introduction. Acute poisonings with corrosive substances may cause serious chemical injuries of the upper gastrointestinal tract, from the mouth to the intestines. They appear as a result of accidental or intentional ingestion of caustic substances and may be found in patients of different ages. The aim of this paper was to present our experience with nutritional support in patients with acute caustic poisonings that hinder normal nutrition. Material and Methods. This retrospective study included 33 patients with a history of corrosive substances abuse (acids, alkali and chlorine bleach), of both sexes, aged above 14 years. Results. Follow-up assessment of our patients has shown a considerable weight loss on day 7 (p<0.001), day 14 (p<0.001), day 21 (p<0.001) and day 28 (p<0.001) after admission to hospital, which is explained with the severe post-corrosive condition of the patients and hypercatabolic state. Conclusion. Caustic poisonings are the most severe poisonings in the clinical practice and they are mostly encountered in younger adults. By application of artificial nutritional support we managed to maintain body weight, level of proteins and albumins, nutritional status and nitrogen balance in our patients.

Based on our study of corrosive poisonings of adults, we propose a list of optimal treatment recommendations.