Evaluation of corrosive poisoning in adult patients

Acehan, Selen; Satar, Salim; Gülen, Müge; Avcı, Akkan

doi:10.1016/j.ajem.2020.01.016

Cited by 9 publications

(9 citation statements)

References 20 publications

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“…The majority of patients (75%) in the current study ingested alkaline caustic agents, this was in accordance with several studied, which proposed that acidic agents usually cause severe immediate pain after ingestion and are rapidly expelled, while alkaline agents have almost imperceptible taste and odor with an easy swallowing, in addition to the wide spread and availability of alkaline agents in homes (Agbara et al, 2019;Acehan et al, 2021). Nevertheless, no significant 2020) reported that alkalis ingestion was associated with higher incidence of complications, higher probability of esophageal stricture and worse endoscopic score compared to acids.…”

Section: Discussionsupporting

confidence: 89%

The Potential Role of Procalcitonin Compared to C-reactive protein and Neutrophil Lymphocyte Ratio in Prediction of Severity and Outcomes of Acute Corrosive Ingestion

Saleh,

Abdel Salam,

Abou Anza

et al. 2024

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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Background: Caustic ingestion in children is considered a serious healthcare issue worldwide due to its high morbidity and mortality rates. Aim: The present study aimed to evaluate the potential role of procalcitonin (PCT) compared to C-reactive protein (CRP) and neutrophil lymphocyte ratio (NLR) in assessment of severity and prediction of outcomes of acute corrosive ingestion for early intervention and better prognosis. Methods: This prospective study was conducted on 60 patients aged from 6 months to 12 years, who were admitted to poison control center, Ain Shams University Hospitals with diagnosis of acute caustic ingestion. Demographic, clinical data and blood samples were collected from each patient, with biomarkers' assessment within 24 hours post caustic ingestion. Results: The majority of patients were males (70%) with median age 1.5 years. Acute and/or chronic complications occurred in 43.3% of the studied patients. Significantly higher levels of PCT, CRP and NLR were detected in complicated patients, as well patients with DROOL score ≤4. Procalcitonin level <1.4 ng/mL was the most specific biomarker (94.12%) with the highest positive predictive value (90.5%) in predicting complications occurrence, whereas CRP level <9.6 mg/L was the most sensitive biomarker (100%). Conclusion: This study supports the role of PCT, CRP and NLR as reliable biomarkers in early predicting the severity and outcomes of corrosive ingestion in children. PCT seemed to be superior to CRP and NLR in predicting complications post caustic ingestion.

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Section: Discussionsupporting

confidence: 89%

The Potential Role of Procalcitonin Compared to C-reactive protein and Neutrophil Lymphocyte Ratio in Prediction of Severity and Outcomes of Acute Corrosive Ingestion

Saleh,

Abdel Salam,

Abou Anza

et al. 2024

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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“…Emergency endoscopy must be performed within the first 48 h after exposure to the toxin, with the optimal interval generally considered to be 12–24 h [ 5 , 36 , 49 , 50 ]. According to Zargar et al, delayed endoscopy (48–96 h after ingestion of corrosive substances) remains safe, and the subacute phase (5 to 15 days after corrosive ingestion) is, in fact, the moment most prone to perforation [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Severe Intentional Corrosive (Nitric Acid) Acute Poisoning: A Case Report and Literature Review

Stoica

Lionte

Palaghia

et al. 2023

JPM

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Despite being one of the most debilitating conditions encountered in the field of toxicology, there is a lack of neutralization measures for the toxins involved in acute corrosive poisoning, and this promotes progressive contact injury of deep tissues after poisoning has occurred. Multiple controversies still surround management strategies during the acute phase of poisoning and the long-term follow-up of the patient. Here, we report a severe case of intentional poisoning with nitric acid complicated by extensive injury of the upper digestive tract, multiple stricture formation, and complete dysphagia. Serial endoscopic dilation and insertion of a jejunostomy feeding tube were necessary, and underlying psychiatric illness negatively affected the outcome of the patient. We conclude that an interdisciplinary approach is necessary to properly reduce the extent of lesions and sequelae induced by corrosion. Early endoscopic mapping of injuries is of major importance to better predict the evolution and possible complications of poisoning. Interventional and reconstructive surgical procedures may significantly improve the life expectancy and quality of life of patients following intoxication with corrosive substances.

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“…A study of corrosive substance intake cases between 01/07/2017 and 01/07/2019 in emergency department of training and research hospital reported that sodium hypochlorite was the most frequent caustic substance ingested, with 51.6% accidental intake and 41.6% suicidal intake. In such cases, endoscopy should be performed as soon as possible, whereas the use of neutralizing treatment is controversial because of the risk of causing thermal injury [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

Health effects of sodium hypochlorite: review of published case reports

Chung

Ryu

Yoon

et al. 2022

Environ Anal Health Toxicol

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Sodium hypochlorite is widely used as the main component of cleaners and has an excellent bleaching and sterilizing effect in living and medical environments. In addition to bleaching, it is used for wastewater treatment and for sterilization in food factories, and also for disinfectants during the COVID-19 pandemic. This study analyzed reports of the health effects of sodium hypochlorite and classified them by toxicity along the exposure pathway. Most case reports described the health effects of acute high-concentration exposure, with a common case being dental exposure, mainly during treatment.

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Evaluation of corrosive poisoning in adult patients

Cited by 9 publications

References 20 publications

The Potential Role of Procalcitonin Compared to C-reactive protein and Neutrophil Lymphocyte Ratio in Prediction of Severity and Outcomes of Acute Corrosive Ingestion

The Potential Role of Procalcitonin Compared to C-reactive protein and Neutrophil Lymphocyte Ratio in Prediction of Severity and Outcomes of Acute Corrosive Ingestion

Severe Intentional Corrosive (Nitric Acid) Acute Poisoning: A Case Report and Literature Review

Health effects of sodium hypochlorite: review of published case reports

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