[Treatment of caustic stenoses of the upper digestive tract].
Stenosis of the upper digestive tract developed in 22 patients with stage IIB or stage III caustic burns due to massive ingestion of an alkaline substance in 18 cases and an acid substance in 4 cases is analysed. Emergency oesogastrectomy without thoracotomy was performed in emergency situations in 10 patients in whom mortality reached 30%. For the remaining 12 patients with minimal stage IIB lesions, a jejunostomy was opened for enteral nutrition. After three months, stenosis developed in 10 cases and required surgical treatment in 7 after failure of endoscopic dilatations. Surgery included retrosternal coloplasy with oesophagectomy for 3 patients. There were no deaths. Two patients with a stenosis of the cervical anastomosis were treated endoscopically. These results suggest that the use of the endoscope in the acute phase can help ascertain the best management technique and confirms that stage IIB stenosis can develop a tight stenosis in 50% of the cases. This situation requires surgical treatment in 70% of the cases.
Service de Chirurgie générale et digestive, Hôpital de la Conception, Marseille.
B
B
Berthet
D
D
Bernardini
T
T
Lonjon
R
R
Assadourian
A
A
Gauthier
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002057:Burns, Chemical / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D002424:Caustics / Q000009:adverse effects*; D016145:Endoscopy, Digestive System; D004940:Esophageal Stenosis / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy; D004944:Esophagoplasty; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D011446:Prospective Studies; D011859:Radiography; D013406:Suicide, Attempted
D002424:Caustics
Traitement des sténoses caustiques du tractus digestif supérieur.