Changes in endoscopic patterns before and during COVID-19 outbreak:Experience at a single tertiary center in Korean

BACKGROUND The surge of coronavirus disease 2019(COVID-19)patients has markedly influenced the treatment policies of tertiary hospitals because of the need to protect medical staff and contain viral transmission,but the impact COVID-19 had on emergency gastrointestinal endoscopies has not been determined.AIM To compare endoscopic activities and analyze the clinical outcomes of emergency endoscopies performed before and during the COVID-19 outbreak in Daegu,the worst-hit region in South Korea.METHODS This retrospective cohort study was conducted on patients aged≥18 years that underwent endoscopy from February 18 to March 28,2020,at a tertiary hospital in Daegu.Demographics,laboratory findings,types and causes of emergency endoscopies,and endoscopic reports were reviewed and compared with those obtained for the same period in 2018 and 2019.RESULTS From February 18 to March 28,a total of 366 emergent endoscopic procedures were performed:Upper endoscopy(170,50.6%),endoscopic retrograde cholangiopancreatography(113,33.6%),and colonoscopy with sigmoidoscopy(53,15.8%).The numbers of procedures performed in 2018 and 2019 dropped by 48.8%and 54.8%,respectively,compared with those in 2020.During the COVID-19 outbreak,the main indications for endoscopy were melena(36.7%),hematemesis(30.6%),and hematochezia(10.2%).Of the endoscopic abnormalities detected,gastrointestinal bleeding was the most common:39 cases in 2018,51 in 2019,and 35 in 2020.CONCLUSION The impact of COVID-19 is substantial and caused dramatic reductions in endoscopic procedures and changes in patient behaviors.Long-term follow-up studies are required to determine the effects of COVID-19 induced changes in the endoscopy field.

Suicidal ingestion of potassium permanganate

BACKGROUND:Potassium permanganate is used clinically as an antiseptic and antifungal agent.Ingestion of potassium permanganate may result in damage to the upper gastrointestinal tract.Burns and ulceration of the mouth,esophagus and stomach occur due to its action.Emergency endoscopy is useful to assess the severity of damage and also to guide management.METHODS:We reported a patient presenting to the emergency department after suicidal ingestion of potassium permanganate.RESULTS:After treatment,the patient was discharged home on the 7th day after admission.CONCLUSION:Early emergency endoscopy should be considered to determine the extent of upper gastrointestinal damage in the emergency department.