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

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 2010–2016 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 exam, details of the hospital course, were collected. Esophago-Gastro-Duodenoscopy (EGD) findings and Direct Laryngoscopy-Bronchoscopy (DLB) 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's exact test. Results: 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. GI symptoms were present in 21 (91%) patients. Exam findings were present in 8/23 (35%) patients. EGD (done by gastroenterologists) evaluation was done in 21 (91%) patients and positive findings were seen in 5/21 (24%) The proportion of patients with positive exam findings was significantly higher in patients with positive EGD findings (80% vs 20%, respectively; p = 0.0307). DLB (done by otolaryngologists) evaluation was done in 6 (26%) patients and positive findings were seen in 4/6 (67%). Conclusion: Our results suggest that oropharyngeal exam findings increase the likelihood of endoscopy findings, hence we recommend endoscopic evaluation of patients who have exam 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. Address correspondence and reprint requests to Avantika Singh, MD, 1200 Children's Ave, Oklahoma City, OK 73104 (e-mail: avantikasingh18@gmail.com). Received 2 January, 2018 Accepted 14 December, 2018 Authors have no financial disclosures or conflicts of interest to disclose. © 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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