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J Korean Soc Emerg Med > Volume 15(6); 2004 > Article
Journal of The Korean Society of Emergency Medicine 2004;15(6): 487-491.
Endoscopic Evaluation of Upper Gastrointestinal Injury in Patients with Noncaustic Drug Ingestion
Yeon Ho You, Jung Kyu Park, Jang Young Lee, Jin Hong Min, Sung Pil Chung, Seung Whan Kim, In Sool You, Jong Seong Kim
1Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejon, Korea. emfire@cnuh.co.kr
2Department of Family Medicine, College of Medicine, Chungnam National University, Daejon, Korea.
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).
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.
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.
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.
Key words: Esophagogastroduodenoscopy, Poisoning
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