Early operation for severe corrosive injury of the upper gastrointestinal tract
Berthet, B.; Castellani, P.; Brioche, M.I.; Assadourian, R.; Gauthier, A.
European Journal of Surgery 162(12): 951-955
1996
ISSN/ISBN: 1102-4151 PMID: 9001876 Document Number: 465691
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.