Avoidance of esophageal stricture following severe caustic burns by the use of an intraluminal stent.
The high incidence of stricture following conventional therapy for caustic esophageal injuries prompted us to incorporate the esophageal stenting technique of Reyes and colleagues [3, 5, 6] into our protocol for management of such patients. Four adult patients were treated following severe esophageal burns caused by the ingestion of caustic drain cleaner. The severity of the burn was established by early esophagoscopy. Laparotomy and gastrotomy revealed severe but nontransmural gastric burns. The stent was left in place for 21 days. Antibiotics and corticosteroids were also employed. There have been no late strictures. One patient required laryngeal dilation for adhesions and another, tracheal dilation for subglottic stenosis. Contrast roentgenographic studies and esophageal manometry have revealed nearly normal esophageal function up to 20 months following the injury.
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002057:Burns, Chemical / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D004322:Drainage; D004940:Esophageal Stenosis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000517:prevention & control; D004945:Esophagoscopy; D004947:Esophagus / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy; D006801:Humans; D007440:Intubation / Q000295:instrumentation / Q000379:methods*; D007441:Intubation, Gastrointestinal / Q000295:instrumentation; D007813:Laparotomy; D008297:Male; D008722:Methods; D011859:Radiography; D012828:Silicones
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D012828:Silicones