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Published in: Journal of Gastrointestinal Surgery 10/2018

01-10-2018 | Original Article

Risk Factors for Esophageal Stricture in Grade 2b and 3a Corrosive Esophageal Injuries

Authors: Prasit Mahawongkajit, Prakitpunthu Tomtitchong, Nuttorn Boochangkool, Palin Limpavitayaporn, Amonpon Kanlerd, Chatchai Mingmalairak, Surajit Awsakulsutthi, Chittinad Havanond

Published in: Journal of Gastrointestinal Surgery | Issue 10/2018

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Abstract

Background and Purpose

Publications document the risk of developing esophageal stricture as a sequential complication of esophageal injury grades 2b and 3a. Although there are studies describing the risk factors of post-corrosive stricture, there is limited literature on these factors. The aim of this study was to evaluate the different factors with post-corrosive esophageal stricture and non-stricture groups in endoscopic grades 2b and 3a of corrosive esophageal injuries.

Methods

Data were retrospectively analyzed in the patients with esophageal injury grades 2b and 3a between January 2011 and December 2017.

Results

One hundred ninety-six corrosive ingestion patients were admitted with 32 patients (15.8%) in grade 2b and 12 patients (6.1%) in grade 3a and stricture was developed in 19 patients (61.3%) with grade 2b and in 10 patients (83.3%) with grade 3a. The patients’ height of the non-stricture group was greater than that of stricture groups (2b stricture group, 1.58 ± 0.08 m; 2b non-stricture group, 1.66 ± 0.07 m; p < 0.004; 3a stricture group, 1.52 ± 0.09 m; 3a non-stricture group, 1.71 ± 0.02 m; p < 0.001). Omeprazole was more commonly used in the non-stricture than stricture group (26.3% in the 2b stricture group, 69.2% in the 2b non-stricture group, p = 0.017; 50% in the 3a stricture group, 100% in the 3a non-stricture group, 1.71 ± 0.02 m, p = 0.015).

Conclusions

The height of patients may help to predict the risks and the prescription of omeprazole may help to minimize the risks of 2b and 3a post-corrosive esophageal stricture.
Literature
1.
go back to reference Havanond C. Clinical features of corrosive ingestion. J Med Assoc Thai. 2003;86(10):918–24.PubMed Havanond C. Clinical features of corrosive ingestion. J Med Assoc Thai. 2003;86(10):918–24.PubMed
2.
go back to reference Awsakulsutthi S, Havanond C. A retrospective study of anastomotic leakage between patients with and without vascular enhancement of esophageal reconstructions with colon interposition: Thammasat University Hospital experience. Asian J Surg. 2015;38(3):145–9.CrossRefPubMed Awsakulsutthi S, Havanond C. A retrospective study of anastomotic leakage between patients with and without vascular enhancement of esophageal reconstructions with colon interposition: Thammasat University Hospital experience. Asian J Surg. 2015;38(3):145–9.CrossRefPubMed
3.
go back to reference Havanond C, Havanond P. Initial signs and symptoms as prognostic indicators of severe gastrointestinal tract injury due to corrosive ingestion. J Emerg Med. 2007;33(4):349–53.CrossRefPubMed Havanond C, Havanond P. Initial signs and symptoms as prognostic indicators of severe gastrointestinal tract injury due to corrosive ingestion. J Emerg Med. 2007;33(4):349–53.CrossRefPubMed
4.
go back to reference Havanond C. Is there a difference between the management of grade 2b and 3 corrosive gastric injuries? J Med Assoc Thai. 2002;85(3):340–4.PubMed Havanond C. Is there a difference between the management of grade 2b and 3 corrosive gastric injuries? J Med Assoc Thai. 2002;85(3):340–4.PubMed
5.
6.
go back to reference Are’valo-Silva C, Eliashar R, Wohlgelernter J, Elidan J, Gross M. Ingestion of caustic substances: a 15-year experience. Laryngoscope. 2006;116(8):1422–6.CrossRef Are’valo-Silva C, Eliashar R, Wohlgelernter J, Elidan J, Gross M. Ingestion of caustic substances: a 15-year experience. Laryngoscope. 2006;116(8):1422–6.CrossRef
7.
go back to reference Pace F, Antinori S, Repici A. What is new in esophageal injury (infection, drug-induced, caustic, stricture, perforation)? Curr Opin Gastroenterol. 2009;25(4):372–9.CrossRefPubMed Pace F, Antinori S, Repici A. What is new in esophageal injury (infection, drug-induced, caustic, stricture, perforation)? Curr Opin Gastroenterol. 2009;25(4):372–9.CrossRefPubMed
8.
9.
go back to reference Goldman LP, Weigert JM. Corrosive substance ingestion: a review. Am J Gastroenterol 1984;79:85–90.PubMed Goldman LP, Weigert JM. Corrosive substance ingestion: a review. Am J Gastroenterol 1984;79:85–90.PubMed
10.
go back to reference Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK. Ingestion of corrosive acids. Spectrum of injury to upper gastrointestinal tract and natural history. Gastroenterology. 1989;97(3):702–7.CrossRefPubMed Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK. Ingestion of corrosive acids. Spectrum of injury to upper gastrointestinal tract and natural history. Gastroenterology. 1989;97(3):702–7.CrossRefPubMed
11.
go back to reference Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK. Ingestion of strong corrosive alkalis: spectrum of injury to upper gastrointestinal tract and natural history. Am J Gastroenterol. 1992;87(3):337–41.PubMed Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK. Ingestion of strong corrosive alkalis: spectrum of injury to upper gastrointestinal tract and natural history. Am J Gastroenterol. 1992;87(3):337–41.PubMed
12.
go back to reference Bonavina L, Chirica M, Skrobic O, Kluger Y, Andreollo NA, Contini S, et al. Foregut caustic injuries: results of the world society of emergency surgery consensus conference. World J Emerg Surg. 2015;10:44.CrossRefPubMedPubMedCentral Bonavina L, Chirica M, Skrobic O, Kluger Y, Andreollo NA, Contini S, et al. Foregut caustic injuries: results of the world society of emergency surgery consensus conference. World J Emerg Surg. 2015;10:44.CrossRefPubMedPubMedCentral
13.
go back to reference Zargar SA, Kochhar R, Mehta S, Mehta SK. The role of fiberoptic endoscopy in the management of corrosive ingestion and modified endoscopic classification of burns. Gastrointest Endosc. 1991;37(2):165–9.CrossRefPubMed Zargar SA, Kochhar R, Mehta S, Mehta SK. The role of fiberoptic endoscopy in the management of corrosive ingestion and modified endoscopic classification of burns. Gastrointest Endosc. 1991;37(2):165–9.CrossRefPubMed
14.
go back to reference Cabral C, Chirica M, de Chaisemartin C, Gornet JM, Munoz-Bongrand N, Halimi B, et al. Caustic injuries of the upper digestive tract: a population observational study. Surg Endosc. 2012;26(1):214–21.CrossRefPubMed Cabral C, Chirica M, de Chaisemartin C, Gornet JM, Munoz-Bongrand N, Halimi B, et al. Caustic injuries of the upper digestive tract: a population observational study. Surg Endosc. 2012;26(1):214–21.CrossRefPubMed
15.
go back to reference Alipour Faz A, Arsan F, Peyvandi H, Oroei M, Shafagh O, Peyvandi M, et al. Epidemiologic Features and Outcomes of Caustic Ingestions; a 10-Year Cross-Sectional Study. Emerg (Tehran). 2017;5(1):e56.PubMedPubMedCentral Alipour Faz A, Arsan F, Peyvandi H, Oroei M, Shafagh O, Peyvandi M, et al. Epidemiologic Features and Outcomes of Caustic Ingestions; a 10-Year Cross-Sectional Study. Emerg (Tehran). 2017;5(1):e56.PubMedPubMedCentral
16.
go back to reference Ramasamy K, Gumaste VV. Corrosive ingestion in adults. J Clin Gastroenterol. 2003;37(2):199–24.CrossRef Ramasamy K, Gumaste VV. Corrosive ingestion in adults. J Clin Gastroenterol. 2003;37(2):199–24.CrossRef
17.
go back to reference Javed A, Pal S, Krishnan EK, Sahni P, Chattopadhyay TK. Surgical management and outcomes of severe gastrointestinal injuries due to corrosive ingestion. World J Gastrointest Surg. 2012;4(5):121–5.CrossRefPubMedPubMedCentral Javed A, Pal S, Krishnan EK, Sahni P, Chattopadhyay TK. Surgical management and outcomes of severe gastrointestinal injuries due to corrosive ingestion. World J Gastrointest Surg. 2012;4(5):121–5.CrossRefPubMedPubMedCentral
18.
go back to reference Lu LS, Tai WC, Hu ML, Wu KL, Chiu YC. Predicting the progress of caustic injury to complicated gastric outlet obstruction and esophageal stricture, using modified endoscopic mucosal injury grading scale. Biomed Res Int. 2014;2014:919870.PubMedPubMedCentral Lu LS, Tai WC, Hu ML, Wu KL, Chiu YC. Predicting the progress of caustic injury to complicated gastric outlet obstruction and esophageal stricture, using modified endoscopic mucosal injury grading scale. Biomed Res Int. 2014;2014:919870.PubMedPubMedCentral
19.
go back to reference Le Naoures P, Hamy A, Lerolle N, Métivier E, Lermite E, Venara A. Risk factors for symptomatic esophageal stricture after caustic ingestion-a retrospective cohort study. Dis Esophagus. 2017;30(6):1–6.CrossRefPubMed Le Naoures P, Hamy A, Lerolle N, Métivier E, Lermite E, Venara A. Risk factors for symptomatic esophageal stricture after caustic ingestion-a retrospective cohort study. Dis Esophagus. 2017;30(6):1–6.CrossRefPubMed
20.
go back to reference Topaloglu B, Bicakci U, Tander B, Ariturk E, Kilicoglu-Aydin B, Aydin O, et al. Biochemical and histopathologic effects of omeprazole and vitamin E in rats with corrosive esophageal burns. Pediatr Surg Int. 2008;24(5):555–60.CrossRefPubMed Topaloglu B, Bicakci U, Tander B, Ariturk E, Kilicoglu-Aydin B, Aydin O, et al. Biochemical and histopathologic effects of omeprazole and vitamin E in rats with corrosive esophageal burns. Pediatr Surg Int. 2008;24(5):555–60.CrossRefPubMed
21.
go back to reference Cakal B, Akbal E, Köklü S, Babalı A, Koçak E, Taş A. Acute therapy with intravenous omeprazole on caustic esophageal injury: a prospective case series. Dis Esophagus. 2013;26(1):22–6.CrossRefPubMed Cakal B, Akbal E, Köklü S, Babalı A, Koçak E, Taş A. Acute therapy with intravenous omeprazole on caustic esophageal injury: a prospective case series. Dis Esophagus. 2013;26(1):22–6.CrossRefPubMed
22.
go back to reference Arisawa T, Harata M, Kamiya Y, Shibata T, Nagasaka M, Nakamura M, et al. Is omeprazole or misoprostol superior for improving indomethacin-induced delayed maturation of granulation tissue in rat gastric ulcers? Digestion. 2006;73(1):32–9.CrossRefPubMed Arisawa T, Harata M, Kamiya Y, Shibata T, Nagasaka M, Nakamura M, et al. Is omeprazole or misoprostol superior for improving indomethacin-induced delayed maturation of granulation tissue in rat gastric ulcers? Digestion. 2006;73(1):32–9.CrossRefPubMed
23.
go back to reference Biswas K, Bandyopatdhyay U, Chattopadyay I, Varadaraj A. A novel antioxidant and anti-apoptotic role of omeprazole to block gastric ulcer through scavenging of hydroxyl radical. J Biol Chem. 2003;278(13):10993–1001.CrossRefPubMed Biswas K, Bandyopatdhyay U, Chattopadyay I, Varadaraj A. A novel antioxidant and anti-apoptotic role of omeprazole to block gastric ulcer through scavenging of hydroxyl radical. J Biol Chem. 2003;278(13):10993–1001.CrossRefPubMed
24.
go back to reference Kil BJ, Kim IW, Shin CY, Jeong JH, Jun CH, Lee SM, et al. Comparison of IY81149 with omeprazole in rat reflux oesophagitis. J Auton Pharmacol. 2000;20(5–6):291–6.CrossRefPubMed Kil BJ, Kim IW, Shin CY, Jeong JH, Jun CH, Lee SM, et al. Comparison of IY81149 with omeprazole in rat reflux oesophagitis. J Auton Pharmacol. 2000;20(5–6):291–6.CrossRefPubMed
25.
go back to reference Kim YJ, Lee JS, Hong KS, Chung JW, Kim JH, Hahm KB. Novel application of proton pump inhibitor for the prevention of colitis-induced colorectal carcinogenesis beyond acid suppression. Cancer Prev Res (Phila). 2010;3(8):963–74.CrossRefPubMed Kim YJ, Lee JS, Hong KS, Chung JW, Kim JH, Hahm KB. Novel application of proton pump inhibitor for the prevention of colitis-induced colorectal carcinogenesis beyond acid suppression. Cancer Prev Res (Phila). 2010;3(8):963–74.CrossRefPubMed
26.
go back to reference Kobayashi T, Ohta Y, Inui K, Yoshino J, Nakazawa S. Protective effect of omeprazole against acute gastric mucosal lesions induced by compound 48/80, a mast cell degranulator, in rats. Pharmacol Res. 2002;46(1):75–84.CrossRefPubMed Kobayashi T, Ohta Y, Inui K, Yoshino J, Nakazawa S. Protective effect of omeprazole against acute gastric mucosal lesions induced by compound 48/80, a mast cell degranulator, in rats. Pharmacol Res. 2002;46(1):75–84.CrossRefPubMed
27.
go back to reference Pozzoli C, Menozzi A, Grandi D, Solenghi E, Ossiprandi MC, Zullian C, et al. Protective effects of proton pump inhibitors against indomethacin-induced lesions in the rat small intestine. Naunyn Schmiedebergs Arch Pharmacol. 2007;374(4):283–91.CrossRefPubMed Pozzoli C, Menozzi A, Grandi D, Solenghi E, Ossiprandi MC, Zullian C, et al. Protective effects of proton pump inhibitors against indomethacin-induced lesions in the rat small intestine. Naunyn Schmiedebergs Arch Pharmacol. 2007;374(4):283–91.CrossRefPubMed
Metadata
Title
Risk Factors for Esophageal Stricture in Grade 2b and 3a Corrosive Esophageal Injuries
Authors
Prasit Mahawongkajit
Prakitpunthu Tomtitchong
Nuttorn Boochangkool
Palin Limpavitayaporn
Amonpon Kanlerd
Chatchai Mingmalairak
Surajit Awsakulsutthi
Chittinad Havanond
Publication date
01-10-2018
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 10/2018
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-018-3822-x

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