Most Common Site of Upper Gastrointestinal Tract Injury in Acid/Alkali Ingestion

Jang, Hye Young; Kim, Sung Eun; Jung, Koo Young; Jung, Sung Ae; Ju, Mi Soon

Abstract

BACKGROUND: It is generally known that while alkali ingestion injures principally the esophagus, acid usually spares the esophagus and damages the stomach mainly. The purpose of this study is to evaluate the most common site of upper gastrointestinal tract injury in acid/alkali ingestion based on endoscopic findings.
METHODS
We retrospectively evaluated 40 patients who ingested acid/alkali for types and amounts of product ingested, time required to undergo endoscopy, and initial endoscopic findings. Endoscopic lesions were graded according to the criteria suggested by Zagar and were graded at the authors'discretion to compare acid injury and alkali injury.
RESULTS
In the acid ingestion group(n=27), the esophagus injury score was 2.55+/-1.18, the stomach injury score was 2.62+/-1.78, and the difference was -0.07+/-1.13, therefore, no significant difference was present(p=0.939). In the alkali ingestion group(n=10), the esophagus injury score was 1.63+/-1.50 and the stomach injury score was 2.63+/-1.20. Stomach injury was significantly more severe than esophageal injury(difference : -1.00+/-1.18, p=0.026, Wilcoxon signed ranks test).
CONCLUSION
While no difference exists between injuries of the esophagus and the stomach due to acid ingestion, the stomach was the most common site in alkali injury.