[Emergency surgical management of lesions from ingestion of caustics. Role of primary endoscopic classification].
Management of caustic ingestion in adults improved in the last decade due to the new diagnostic developments, the better predictability of injuries from signs and symptoms, the intensive care improvements and the more aggressive surgical approach for the most severe lesions. In fact, the early surgical treatment of severe lesions for ingestion of caustic and corrosive substances may reduce mortality, morbidity and hospitalization. The role of early endoscopic examination is today worldwide accepted: is herein proposed a new endoscopic classification of caustic lesions adjusted after a retrospective analysis of a twenty years experience in this field, and applied in twelve patients affected by severe esophageal and gastric injuries then submitted to emergency surgical treatment and survived. It showed a great usefulness in selection of patients to submit immediately to surgery and may play a fundamental role in indications and timing of surgical management of severe injuries by caustic ingestion.
Istituto di Chirurgia d'Urgenza Università di Milano, IRCCS Ospedale Maggiore di Milano.
L
L
Tognini
M
M
Gavinelli
G L
GL
Scacchi
E
E
Martino
P
P
Padalino
F
F
Belloli
G A
GA
Tiberio
M
M
Massari
G
G
Tiberio
D000328:Adult; D002057:Burns, Chemical / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D002424:Caustics / Q000009:adverse effects*; D004064:Digestive System / Q000293:injuries*; D013505:Digestive System Surgical Procedures / Q000592:standards*; D004638:Emergency Treatment; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies
D002424:Caustics
Indicazioni alla chirurgia d'urgenza nelle lesioni da ingestione di caustici. Ruolo di una classificazione endoscopica originale.