OBJECTIVE: To describe our experience of treating severe corrosive burns of the upper gastrointestinal (GI) tract. DESIGN: Open study. SETTING: Teaching hospital, France. SUBJECTS: 18 patients who had swallowed an alkaline substance (caustic soda in 10 cases) and 4 who had swallowed either hydrochloric or sulphuric acid. INTERVENTIONS: Endoscopy was done a mean of 4 hours after the substance had been swallowed. 10 patients underwent oesophagogastrectomy without thoracotomy. MAIN OUTCOME MEASURES: Morbidity and mortality. RESULTS: 4 of the 10 patients died and 3 developed postoperative complications. Of the 12 patients treated by feeding jejunostomy 7 developed stenosis that required operation and 3 developed stenosis that responded to dilatation. None of the 12 died. CONCLUSIONS: Early oesophagoscopy allowed optimal management. Patients died if they swallowed more than 60 ml of a strong alkaline substance. When patients are treated conservatively about half will develop stenoses that require operation.
OBJECTIVE: To describe our experience of treating severe corrosive burns of the upper gastrointestinal (GI) tract. DESIGN: Open study. SETTING: Teaching hospital, France. SUBJECTS: 18 patients who had swallowed an alkaline substance (caustic soda in 10 cases) and 4 who had swallowed either hydrochloric orsulphuric acid. INTERVENTIONS: Endoscopy was done a mean of 4 hours after the substance had been swallowed. 10 patients underwent oesophagogastrectomy without thoracotomy. MAIN OUTCOME MEASURES: Morbidity and mortality. RESULTS: 4 of the 10 patients died and 3 developed postoperative complications. Of the 12 patients treated by feeding jejunostomy 7 developed stenosis that required operation and 3 developed stenosis that responded to dilatation. None of the 12 died. CONCLUSIONS: Early oesophagoscopy allowed optimal management. Patients died if they swallowed more than 60 ml of a strong alkaline substance. When patients are treated conservatively about half will develop stenoses that require operation.
Authors: Yoram Kluger; Ofir Ben Ishay; Massimo Sartelli; Amit Katz; Luca Ansaloni; Carlos Augusto Gomez; Walter Biffl; Fausto Catena; Gustavo P Fraga; Salomone Di Saverio; Augustin Goran; Wagih Ghnnam; Jeffry Kashuk; Ari Leppäniemi; Sanjay Marwah; Ernest E Moore; Miklosh Bala; Damien Massalou; Chirica Mircea; Luigi Bonavina Journal: World J Emerg Surg Date: 2015-10-16 Impact factor: 5.469