Citation

Rajabi MT, Maddah G, Bagheri R, Mehrabi M, Shabahang H, Lorestani F. Iranian Journal of Otorhinolaryngology 2015; 27(78): 15-21.

Copyright

(Copyright © 2015)

DOI

unavailable

PMID

unavailable

Abstract

INTRODUCTION: Caustic ingestion is responsible for a spectrum of upper gastrointestinal tract injury from self-limited to perforation. This study conducted to evaluate clinical characteristics as well as surgical outcomes in patients with caustic ingestion.

MATERIALS AND METHODS: Between Nov1993 to march 2011, 14 adults with a clinical evidence of corrosive ingestion were admitted into our institutions (Omid and Ghaem hospitals). Patients evaluated for etiology of erosion, location, type of surgery, morbidity and mortality after surgery.

RESULTS: 14 patients (10men and 4 women) with a age range between18-53 years were evaluated. In 6 patients, the injury was accidental and in 8 patients ingestion was a suicide attempt. Ingested agent included nitric acid in 4 patients, hydrochloric acid in 7 patients, sulfuric acid in 2 patients and strong alkali in one patient. The location and extent of lesion varied included esophagus in 13 cases, stomach in 7 cases and the pharynx in 3 cases. Acute abdomen was developed In 2 patients and a procedure of total gasterectomy and blunt esophagectomy was performed. In the remaining patients, substernal esophageal bypass in 2 patients, esophageal resection and replacement surgery in 9 patients and gastroenterostomy in one patient performed to relieve esophageal stricture. Two patients died of mediastinitis after esophageal replacement surgery. Postoperative strictures were developed in 2 survived patients with hypopharyngeal reconstruction that was managed by per oral bougienage in one patient and KTP Laser and stenting in the other patient.

CONCLUSION: Esophageal resection with replacement was safe and good technique for severe corrosive esophageal stricture with low mortality and morbidity.

Language: en

Keywords

adolescent; adult; human; female; male; suicide attempt; treatment outcome; hydrochloric acid; morbidity; larynx disorder; clinical article; middle aged; caustic burn; Caustic ingestion; alkali; esophagus burn; sulfuric acid; neck injury; stent; bypass surgery; surgical mortality; pylorus stenosis; esophagus injury; Esophageal stricture; esophagus resection; Article; potassium hydroxide; gastroesophageal reflux; accidental injury; esophagus stenosis; nitric acid; young adult; esophagus prosthesis; jejunostomy; bougie; mediastinitis; colon interposition; acute abdomen; anastomosis stenosis; esophageal bypass; Esophageal replacement; gastroenterostomy; neck anastomotic fistula; pharynx caustic burn; potassium titanyl phosphate laser; stomach caustic burn; subphrenic abscess; supraglottic stricture; total stomach resection