Epidemiology of Caustic Esophagitis and Factors Associated with the Severity of Endoscopic Lesions in the City of Bouake in Ivory Coast

Abstract

Objective: To identify the clinical and endoscopic characteristics of caustic esophageal burns and the factors associated with the severity of lesions in a semi-rural setting. Patients and methods : This was a retrospective descriptive and analytical study based on gastroscopy reports from various digestive endoscopy centers in the city of Bouaké, covering the period from January 2018 to December 2022. All patients who underwent gastroscopy within 7 days following caustic ingestion were included. Results: Of the 7491 upper gastrointestinal endoscopies performed during the study period, only 39 cases were included, yielding a prevalence of 0.52%. The study population comprised 23 men and 16 women, with a sex ratio of 1.44. The mean age was 23.2 years (range: 1 to 83 years). A total of 28.21% of the patients came from rural areas. The ingested caustic substance was alkaline in 53.85% of cases. Suicidal intent was noted in 58.97% of cases. Clinical manifestations were observed in 69.23% of patients, with odynophagia being the most common symptom (70.37%). Mucosal abnormalities were found in 64.10% of patients. According to the Zargar classification, 38.46% of the observed lesions were severe. Analytical analysis revealed that living outside the city and ingestion of an acidic substance were significantly associated with the severity of the lesions. Conclusion: Caustic ingestion in the semi-rural population of Bouaké primarily affected young individuals in a suicidal context. ENT symptoms were relatively frequent, and endoscopy revealed a high proportion of severe lesions which is significantly associated with residence outside the city and with acid ingestion. These findings are consistent with data from urban populations.