APPROACH TO CAUSTIC ESOPHAGEAL AND GASTRIC BURNS

Abstract

Caustic burns of the esophagus and stomach are serious injuries which frequently require surgical or medical treatment. Sixty-two patients were admitted to the Emergency Surgery service of University of İstanbul, İstanbul Medical School between January 1995 and January 2001. Thirty-five patients with clinical and/or endoscopic signs of caustic burns were included in this study. Twenty-four of these patients were hospitalized. Twenty-two patients underwent endoscopy, 10 of whom had Grade I, 12 had Grade II esophagitis. Furthermore; two patients with Grade II esophagitis had gastric, and one patient had gastro-duodenal burns. Six patients (17%) with signs of acute abdomen required urgent laparotomy. Four of these patients had esophageal necrosis and gastric perforation, one had local necrosis in the gastric fundus, and one had normal findings. Two patients (5.7%) who had gone surgical operation died on the lst and 10th day of operation. One patient with Grade II esophagitis and stomach burn was lost by sudden respiratory arrest although there was regression of the endoscopic findings. The mean follow-up period was 10 months. One patient with esophageal and gastric burn presented with pyloric stenosis, which reguired pyloroplasty. One patient with esophagectomy, expired following reconstruction after 9 months. Stricture was not detected in our nonoperative cases. In corosive burn cases, early admission to the hospital, clinical and endoscopic close follow-up, early surgery when required, reduces morbidity and mortality significantly.