Surgical management and outcomes of severe gastrointestinal injuries due to corrosive ingestion

作     者：Amit Javed Sujoy Pal Elan Kumaran Krishnan Peush Sahni Tushar Kanti Chattopadhyay 

作者机构：Department of Gastrointestinal Surgery and Liver TransplantationAll India Institute of Medical Sciences 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2012年第4卷第5期

页      面：121-125页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Caustics Esophagus Esophageal stenosis Dysphagia 

摘      要：AIM:To report our experience in the surgical management of severe injuries of the gastrointestinal tract due to corrosive ***:A retrospective review of patients who underwent emergency surgery for severe gastrointestinal injuries following corrosive ingestion between 1983 and 2010 was carried *** was extracted from a prospectively maintained esophageal disease *** corrosive injuries were defined as full thickness necrosis with perforation of the esophagus or the stomach(with or without involvement of the adjacent viscera) with resultant mediastinitis or ***:Between 1983 and 2010,209 patients with corrosive injury of the esophagus were *** these,13(6.2%) patients underwent emergency surgery for severe corrosive *** median age of the patients was 22 years and the median interval between ingestion of the corrosive substance and surgery was 24 *** surgical procedures done included esophagogastrectomy alone(n = 6),esophagogastrectomy withduodenectomy(n = 4),esophagogastrectomy with pancreaticoduodenectomy(n = 1),esophagogastrectomy with splenectomy(n = 1) and distal gastrectomy with duodenectomy(n = 1).Two patients died in the postoperative period and one after discharge awaiting the second *** factors significantly predictive of mortality following such an injury included renal failure at the time of initial presentation,presence of metabolic acidosis,delay of more than 24 h between corrosive ingestion and surgery,and corrosive induced adjacent organ injury(pancreatic)(P 0.001,0.02,0.005 and 0.015 respectively).Ten patients underwent subsequent surgery for restoration of the alimentary tract continuity with a colonic pull-up(n = 8) and gastrojejunostomy(n = 1).In one patient,the attempted colon pull-up failed due to extensive scarring of the *** median follow up(following restoration of continuity of the gastrointestinal tract) was 36.5 *** patient developed dysphagia due to a strictur