Upper Gastrointestinal Endoscopic Evaluation Following Household Sodium Hypochlorite Ingestion

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Abstract

Endoscopy is generally speculated to be unnecessary in sodium hypochlorite (NaClO) ingestions; however, a significant number of endoscopic evaluations are still being performed when this chemical is ingested. Therefore, the aim of the current study was to compare the outcome and endoscopic findings between patients who had ingested household NaClO and those who had ingested other types of corrosives. This retrospective cohort study enrolled 137 patients with a history of corrosive substance ingestion admitted to a tertiary hospital. Data were extracted from hospital records, and interviews were performed on follow-up. Demographic characteristics, endoscopic findings, and patient outcome were compared between those who had ingested household NaClO and those who ingested other corrosives (NaClO and control cohorts, respectively). Most patients (73%) had attempted suicide. Dysphonia (P ≤ .001), dysphagia (P = .04), and mouth burns (P = .047) were significantly different between the NaClO and control cohorts. Furthermore, patients who had dysphonia, dysphagia, skin burns, drooling, hematemesis, retrosternal pain, and abnormal abdominal examination were prone to death or severe complications. None of the NaClO cohort patients had severe endoscopic complications. All patients in the NaClO cohort survived without any sequelae (OR [95% CI] = 0.87 [0.80–0.94]) while 6 and 5 patients died and developed severe complications in the control cohort, respectively. Studies on endoscopic evaluations in patients who ingested household NaClO are scarce. Our results show that if there are no major clinical manifestations, urgent endoscopic evaluations are unnecessary in such patients.

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