Do pediatric patients require endoscopy after ingesting a laundry pod?

September 8, 2014, 5:16 pm

Laundry_pod2★★★☆☆

Laundry Detergent Pod Ingestions: Is There a Need for Endoscopy? Smith E et al. J Med Toxicol 2014 Sep;10(3):286-91

Abstract

The authors never answer their title question definitively, but you wouldn’t expect that they’d be able to on the basis of this small case series and the limited data published to date.

Ingestion of laundry detergent pod (LDP) ingredients can present with manifestations affecting a number of systems:

  • Gastrointestinal
  • Pulmonary
  • Neurological
  • Metabolic

The paper presents 3 cases of pediatric LDP ingestion in patients ages 13 months to 3 years. Presenting signs and symptoms included vomiting, stridor, respiratory distress, cyanosis, lethargy and decreased level of consciousness, and lactic acidosis. One child required intubation for respiratory distress. No child had visible oropharyngeal lesions but all had superficial esophageal erythema or sloughing. One child developed swallowing abnormality and evidence of silent aspiration on a barium swallow study.

In their discussion, the authors note that the contents of LDPs are in fact less alkaline than the corresponding loose detergents. They do contain propylene glycol, which may be responsible for the drowsiness and lactic acidosis often seen in these patients.

The authors conclude:

If a patient presents with significant gastrointestinal symptoms, including persistent vomiting, dysphagia, drooling, or oral aversion, it is reasonable to evaluate with an upper endoscopy.

They do note, however, that they were unable to find any reported cases of esophageal stricture after LDP ingestion.

 

Related posts:

Laundry ‘pods’: more toxic than your mom’s detergent

Just when you thought it was safe to go back to the laundry room . . .

Look-alike tox: is it a laundry detergent, or a piece of candy?

 

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