Epidemiological Characteristics, Spectrum of Upper Gastrointestinal Tract Injuries and Burden of Corrosive Intake Patients in A Tertiary Care Hospital in Islamabad

Hyder Wajid Abbasi, Warda Aftab, Sara Shahid, Mashood Ali, Javeria Zahid, S. Naz, Amna Ishtiaq
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Abstract

Objective: To investigate the epidemiology and spectrum of upper gastrointestinal (UGI) tract injuries, as well as to assess the burden of Corrosive intake patients who presented to an Islamabad tertiary care hospital.Study Design: Descriptive cross-sectional.Place and Duration of Study: The study was carried out at the Department of Gastroenterology of Pakistan Institute of Medical Sciences, Islamabad, Pakistan from January 2021 to December 2021.Materials and Methods: A retrospective descriptive study was carried out at the department of Gastroenterology using patient records. After taking a thorough history, patients were admitted in the hospital, which was followed by a physical examination, necessary investigations, and an initial emergency management. The study did not include any follow-up cases. Corrosive ingestion induced tissue damage was assessed via endoscopy using Zargar’s classification. The data was analyzed using SPSS version 26.Results: The total number of patients who were brought to emergency department with corrosive ingestion during one year were 74. There were 45 females (60.81%) and 29 male patients (39.19%). Age ranged from 13 to 60 years (mean 27.01 ± 18.91) with highest incidence in the age group of 21-30 years which was 44.59 % followed by 11-20 age Group (28.28 %).  41 patients were unmarried (55.41%), whereas 33 were married (44.59 %). Corrosive ingestion was most common in illiterate patients (44.59 %). 46 patients (62.16%) confessed that they ingested corrosive substance intentionally while 28 (37.84 %) claimed it happened due to accidental ingestion. Washroom cleaner was found to be the most commonly used corrosive Agent (90.54%). The most common sites that sustained corrosive injuries were the oropharynx and oesophagus, while the duodenum was found to be the least affected with normal endoscopic examination in the majority of the patients (51.35 %).Conclusion:  In developing countries, corrosive ingestion is a major public health concern, with a high proportion of suicidal ingestions. It is particularly common in suicidal young people with easy access to washroom cleaners. The seriousness of this problem emphasises the importance of pursuing multidisciplinary solutions. In addition, strict action and stringent legislation by governing bodies are required in developing countries to limit adults' unrestricted access to hazardous corrosive elements.
伊斯兰堡某三级医院腐蚀性药物摄入患者的流行病学特征、上胃肠道损伤谱和负担
目的:了解伊斯兰堡某三级医院上胃肠道损伤的流行病学和频谱,并评估吸入腐蚀性药物的患者的负担。研究设计:描述性横断面。研究地点和时间:研究于2021年1月至2021年12月在巴基斯坦伊斯兰堡巴基斯坦医学科学研究所消化内科进行。材料和方法:在消化内科使用患者记录进行回顾性描述性研究。在详细了解病史后,患者入院,随后进行体格检查、必要的调查和初步急救处理。该研究不包括任何随访病例。通过内窥镜使用Zargar分类评估腐蚀性摄入引起的组织损伤。数据采用SPSS 26进行分析。结果:1年内因腐蚀性食入急诊74例。其中女性45例(60.81%),男性29例(39.19%)。年龄范围13 ~ 60岁(平均27.01±18.91),其中21 ~ 30岁发病率最高,占44.59%,其次是11 ~ 20岁,占28.28%。未婚41例(55.41%),已婚33例(44.59%)。文盲患者以腐蚀性食入最为常见(44.59%)。46例(62.16%)患者承认故意误食腐蚀性物质,28例(37.84%)患者认为是意外误食。洗手间清洁剂是最常用的腐蚀剂(90.54%)。胃镜下腐蚀损伤最常见的部位是口咽部和食道,而十二指肠在大多数患者(51.35%)中最不受影响。结论:在发展中国家,腐蚀性摄入是一个主要的公共卫生问题,自杀性摄入的比例很高。这在有自杀倾向的年轻人中尤其常见,因为他们很容易找到洗手间清洁工。这一问题的严重性强调了寻求多学科解决办法的重要性。此外,发展中国家需要理事机构采取严格的行动和严格的立法,限制成年人无限制地接触有害的腐蚀性元素。
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