dont u observe ---is scopy not CI for poison? - newboy

[ArchivalUser]

A 26-year-old man is admitted to the hospital after accidental ingestion of corrosive alkali liquid. He denies any past medical or surgical history. The day before admission, he was at a party with his friends where he consumed a lot of alcohol. At the end of the party, he returned home and accidentally ingested corrosive alkali liquid from a bottle, mistaking it for a bottle of water. At the time of admission to the hospital, he complained of substernal chest pain and that he was feeling "really ill". Initial gastrointestinal contrast study with water-soluble contrast did not reveal a gastrointestinal leak or perforation. His vitals are stable with a tachycardia of 90/min. The next best step in management is to
A. continue to observe him in the hospital
B. order a CT scan of the chest
C. order an electrocardiogram
D. order an upper gastrointestinal study with barium
*E. perform an upper gastrointestinal endoscopy

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cos chances of perforation so isnt scopy C.I in poisoning?

[ArchivalUser]

?

[ArchivalUser]

well, from what i've read, esophagoscopy is req in symptomatic patients to decide further management (whether there's a stricture or not will decide the next course of action). So I think the benefit of doing an eso'scopy in these cases must outweigh the risk of a perforation. If the pt. is asym, then observn alone suffices.

[ArchivalUser]

RECOMEENDATIONS SAY THAT ENDOSCOPY MUST BE DONE WITHIN 24 HRS OF INGESTION OF LYE IF PERF HAS BEEN RULED OUT USING GASTORGRAFFIN