Surgical results of corrosive injuries involving esophagus to jejunum.
OBJECTIVE
Severe corrosive injury involving esophagus to jejunum remains an unique surgical problem which is associated with high mortality and morbidity.


METHODS
Herein we report the outcomes of 28 caustic patients who underwent resections of the stomach, duodenum, a segment of jejunum, and adjacent involving organs.


RESULTS
In all of these patients except one, esophagectomy was also performed. The concomitant procedures included pancreaticojejunostomy (n = 24), choledochojejunosotmy (n = 4), cholecystostomy (n = 4), common bile duct or pancreatic duct drainage, feeding and drainage jejunostomies, and cervical esophagostomy. Major complications consisted of bile leakage (n = 10), bile-bronchial fistula (n = 2), internal bleeding due to vessel necrosis (n = 5), peritonitis (n = 4), acute renal failure (n = 4), and septicemia (n = 4). There were 13 hospital deaths (46.4%) and three late deaths. Eight out of 12 survivors underwent subsequent reconstruction of esophagus. The remaining four survivors depended on jejunostomy feeding.


CONCLUSIONS
Early approaches and appropriate procedures can save a number of patients with corrosive injury involving esophagus to jejunum.
Wu
M H
MH
National Cheng-Kung University Hospital, Tainan, Taiwan.
Lai
W W
WW
Hwang
T L
TL
Lee
S C
SC
Hsu
H K
HK
Lin
T S
TS
D000328:Adult; D002057:Burns, Chemical / Q000401:mortality / Q000601:surgery*; D004066:Digestive System Diseases / Q000139:chemically induced* / Q000401:mortality / Q000601:surgery*; D013505:Digestive System Surgical Procedures; D004940:Esophageal Stenosis / Q000139:chemically induced* / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D009017:Morbidity; D010193:Pancreaticojejunostomy; D011183:Postoperative Complications / Q000453:epidemiology; D013997:Time Factors