J Korean Soc Emerg Med.  2004 Dec;15(6):487-491.

Endoscopic Evaluation of Upper Gastrointestinal Injury in Patients with Noncaustic Drug Ingestion

• You YH
• Park JK
• Lee JY
• Min JH
• Chung SP
• Kim SW
• You IS
• Kim JS

Abstract

PURPOSE
There have been few studies of the direct effect of a drug overdose on the gastrointestinal (GI) mucosa. This study evaluated the frequency of GI mucosal injury and the necessity for esophagogastroduodenoscopy (EGD) in patients with non-caustic drug ingestion (DI).
METHODS
Patients who presented to the emergency department with non-caustic DI from January 2001 to December 2003 were enrolled in this study. EGD was performed on the patients after acute toxicologic management. Those who did not consent to EGD were excluded. The EGD findings were analyzed according to the non-caustic drug that had been ingested.
RESULTS
Among the 37 patients, 24 (65%) had significant endoscopic lesions. Endoscopic findings were gastric erosion (n=17), ulcers (n=5), esophageal erosion (n=1), and a gastric hemorrhage (n=1). Pesticides, rodenticides, salicylates, and high dose doxylamine (>5 g) were associated with drug-induced gastropathy.
CONCLUSION
This study suggests that GI mucosal injury has been underestimated in DI patients and that a treatment for gastromucosal protection should be performed when the non-caustic ingested drug is a pesticides, a rodenticides, a salicylates or high-dose doxylamine.

Keyword

Esophagogastroduodenoscopy; Poisoning

MeSH Terms

Doxylamine
Drug Overdose
Eating*
Emergency Service, Hospital
Endoscopy, Digestive System
Hemorrhage
Humans
Mucous Membrane
Pesticides
Poisoning
Rodenticides
Salicylates
Ulcer
Doxylamine
Pesticides
Rodenticides
Salicylates