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Clinical and Endoscopy Findings in Children With Accidental Exposure to Concentrated Detergent Pods

Singh, Avantika*; Anderson, Michael; Altaf, Muhammad A.*

Journal of Pediatric Gastroenterology and Nutrition: June 2019 - Volume 68 - Issue 6 - p 824–828
doi: 10.1097/MPG.0000000000002270
Original Articles: Gastroenterology
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Background: Caustic ingestion with concentrated detergent pods (CDPs) is a common problem encountered in pediatric population. There is insufficient literature about endoscopic findings in CDP ingestion and hence no current consensus or guidelines regarding the need for endoscopic evaluation.

Objectives: To review cases of children with exposure to CDPs from 2010 to 2016 at a tertiary care children's hospital and to identifying the possibility of a correlation between clinical presentation and the endoscopic findings.

Methods: A retrospective review identified pediatric patients with accidental caustic exposure to CDPs. Data on demographics, type of exposure, clinical symptoms, physical examination, details of the hospital course were collected. Esophagogastroduodenoscopy (EGD) findings and direct laryngoscopy-bronchoscopy findings were also collected. Descriptive statistics were computed for all demographic and clinical variables. The association between EGD findings and clinical presentation were tested using Fisher exact test.

Results: A total of 23 (28%) cases of CDP ingestion were identified out of 83 total cases of caustic ingestion between January 2010 and June 2016. Median age was 15 months. gastrointestinal symptoms were present in 21 (91%) patients. Examination findings were present in 8 of 23 (35%) patients. EGD (done by gastroenterologists) evaluation was done in 21 (91%) patients and positive findings were seen in 5 of 21 (24%). The proportion of patients with positive examination findings was significantly higher in patients with positive EGD findings (80% vs 20%, respectively; P = 0.0307). Direct laryngoscopy-bronchoscopy (done by otolaryngologists) evaluation was done in 6 (26%) patients and positive findings were seen in 4 of 6 (67%).

Conclusions: Our results suggest that oropharyngeal examination findings increase the likelihood of endoscopy findings; hence, we recommend endoscopic evaluation of patients who have examination findings secondary to exposure to CDPs. In other patients, it will be reasonable to evaluate the need for endoscopy on a case-by-case basis.

*Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition

Department of Pediatrics, University of Oklahoma Health Sciences Center, The Children's Hospital at OU Medical Center, Oklahoma City, OK.

Address correspondence and reprint requests to Avantika Singh, MD, Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition, University of Oklahoma Health Sciences Center, The Children's Hospital at OU Medical Center, 1200 Children's Ave, Oklahoma City, OK 73104 (e-mail: avantikasingh18@gmail.com).

Received 2 January, 2018

Accepted 14 December, 2018

The authors report no conflicts of interest.

© 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,