ACCIDENTAL BLEACH INGESTION IN CHILDREN - RESULTS OF A METAANALYSIS OF 11 FRENCH POISON CENTERS RECOMMENDATIONS - PROPOSALS OF A THERAPEUTIC GUIDE-LINE

Accidental bleach ingestion is frequent in children but there is no ag reement on its management. The results of a survey among 11 French poi son centres about their recommendations in this intoxication are repor ted. Most of the centres adapt their guidelines according to the quant ity and the concentration of the ingested bleach. In case of diluted b leach, no centre recommends an hospitalization when the quantity is sm aller than 100 ml, whereas four of the 11 centres recommend it when th e quantity is greater than 100 ml. In case of concentrate bleach inges tion nine of the 11 centres recommend an hospitalization whatever the amount, eight of them performing an emergency upper gastro intestinal (GI) endoscopy if clinical signs are present. In case of large ingesti on of concentrate bleach ten centres recommend the hospitalization, ei ght perform an upper GI endoscopy between 6 and 8 hours post ingestion according to clinical signs, and two perform a systematic emergency u pper GI endoscopy. Tablets and new bleach are considered as concentrat e bleach. From these informations and a review of the literature, the authors emphasize the importance of the clinical signs as criteria for prediction of GI lesions regardless of the quantity or the concentrat ion of ingested bleach.