Emergency treatment of esophago-gastric lesion in caustic ingestion patients

Excerpt

The ingestion of caustic substance can produce severe injury not only to the esophagus, but also to the gastrointestinal tract and can even result in death. The degree and extent of damage depends on several factors like the type of substance, the quantity, and the intent; the quantity is a prognostic value: 20–50 ml = severe, >50 ml = very severe. In the acute phase, perforation and necrosis may occur often with devastating consequences on the esophagus and the stomach; the injuries are associated with high mortality and morbidity rates when mediastinitis, gastrobronchial fistula, chemical peritonitis, or perforation of the gastrointestinal tract occurs. Perforation may occur in the late phase, especially with the ingestion of alkaline solution, because the inflammation invades more deeply with the continuous release of OH^- after coming into contact with protein. Long-term complications include stricture formation in the esophagus, antral stenosis and the development of esophageal carcinoma. The aim of this study is to evaluate whether early diagnosis and surgical treatment are essential to improve the prognosis. …