[Accidental bleach ingestion in children: results of a survey in 11 anti-poison centres. Proposals for management]

Accidental bleach ingestion is frequent in children but there is no agreement on its management. The results of a survey among 11 French poison centres about their recommendations in this intoxication are reported. Most of the centres adapt their guidelines according to the quantity and the concentration of the ingested bleach. In case of diluted bleach, no centre recommends an hospitalization when the quantity is smaller than 100 ml, whereas four of the 11 centres recommend it when the quantity is greater than 100 ml. In case of concentrate bleach ingestion 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 ingestion of concentrate bleach ten centres recommend the hospitalization, eight perform an upper GI endoscopy between 6 and 8 hours post ingestion according to clinical signs, and two perform a systematic emergency upper GI endoscopy. Tablets and new bleach are considered as concentrate 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 concentration of ingested bleach.