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Clinical Spectrum and Implications of Corrosive Oesophageal Injuries in Northern Nigeria

Mohammed Bello Fufore, Abdullahi Musa Kirfi, Jamila Lawal, Mohammad Sani

Background: Corrosive ingestion is a serious public health issue associated with high morbidity and mortality. Caustic soda is the most common corrosive substance ingested in developing countries. Caustic soda is used for making soap by local methods in many poor countries, particularly in households with poor or low socio-economic status; this substance is colourless, odourless and usually kept inside bottles and can be confused with water and can be accidentally ingested. This study aimed to evaluate the clinical profile and management of corrosive oesophageal injuries at a referral centre in Kaduna Nigeria. Methods: A 9-year (January 2010 to December 2018) retrospective study of patients managed for corrosive oesophageal injuries at a tertiary referral centre in Kaduna. Ethical approval was obtained from the hospital’s ethics committee. Patients’ medical records were reviewed and relevant information on socio-demographic, clinical features, treatments and complications were obtained. The data was analysed using SPSS version 20. Descriptive statistics was used to ascertain the frequencies and distribution of the variables. Results: A total of 15 patients were seen over the study period. The age range was 2-19 years with median of 5.3 years. Nine (60.0%) were males with a M:F ratio of 1.5:1. Majority (93.3%) had accidental ingestion and 53.3% of the ingestions occurred in the neighbourhood. Caustic soda accounted for 86.7% of the ingestions and more than half (53.3%) presented after 48 hours of ingestion (late presentation). Seven (46.7%) developed complications; of these, 4/7 (57.1%) presented after 48 hours of ingestion. Four patients had short segment strictures, three had oesophageal perforation while two died from the complications. Conclusions: Corrosive ingestion was mostly seen in male children, majority was accidental ingestion and in most instances caustic soda was implicated. Late presentation was associated with severe complications.